title: [Septal delineation using a 20 % diluted contrast chaser bolus in coronary CT angiography: a comparison of 64-slice and dual source CT].
abstract: OBJECTIVE
  Due to the technical advance of multislice cardiac CT and the recently introduced dual source CT, the acquisition times for cardiac CT exams are < 10 sec. At the same time the assessment of left ventricular function is possible. However, in many patients a complete right ventricular outwash is noted, leading to insufficient septal delineation. Studies were able to demonstrate that contrast media (CM) mixed in the saline chaser bolus is sufficient for significantly better visualization of septal structures. The aim of this study was to investigate whether this dual flow concept works as well for 64-slice and dual source CT angiography using only 20 % CM in the saline chaser bolus.
  
  
  METHODS
  97 patients were included in this prospective study. 47 patients underwent 64-slice CT coronary angiography. 80 cc were administered at 5 cc/sec as the main bolus followed by a 50 cc saline chaser bolus containing 20 % contrast media. The other 50 patients were examined using dual source CT. They received a CM protocol adapted for the scan time with the identical saline/CM chaser bolus. The datasets were quantitatively examined in defined ROIs along the septum and in the right ventricle with respect to the density. The septal delineation was qualitatively analyzed and both groups were compared. In a final step the density was measured in the proximal and distal RCA as well as in the LAD and also compared.
  
  
  RESULTS
  Using the protocol adapted for the scan time, significantly less CM was used. No significant difference was able to be found regarding the septal delineation or coronary enhancement.
  
  
  CONCLUSIONS
  The study shows that the dual flow concept allows for robust septal delineation regardless of the CM injection protocol used as long as a 20 % saline chaser bolus is used. A CM protocol adapted for the scan time also leads to significant CM reduction at equal image quality.
authors.affiliation: Radiologisches Institut, Friedrich-Alexander-Universität Erlangen-Nürnberg.
authors.forename: W
authors.initials: W
authors.lastname: Wüst
authors.forename: C
authors.initials: C
authors.lastname: Zunker
authors.forename: M
authors.initials: M
authors.lastname: May
authors.forename: K
authors.initials: K
authors.lastname: Anders
authors.forename: D
authors.initials: D
authors.lastname: Ropers
authors.forename: S
authors.initials: S
authors.lastname: Achenbach
authors.forename: M
authors.initials: M
authors.lastname: Uder
authors.forename: A
authors.initials: A
authors.lastname: Kuettner
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media / Q000008:administration & dosage*; D017023:Coronary Angiography / Q000379:methods*; D005260:Female; D006346:Heart Septum / Q000000981:diagnostic imaging*; D006801:Humans; D007479:Iopamidol / Q000008:administration & dosage / Q000031:analogs & derivatives*; D008297:Male; D008875:Middle Aged; D011856:Radiographic Image Enhancement / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012965:Sodium Chloride / Q000008:administration & dosage; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media; C057937:iomeprol; D012965:Sodium Chloride; D007479:Iopamidol