title: Multidetector CT imaging of pleura: comparison of two contrast infusion protocols.
abstract: OBJECTIVE
  Imaging of the pleura by multidetector CT (MDCT) can be challenging. There is no clear evidence or guidelines on contrast infusion parameters for imaging pleura. We compared two contrast protocols for assessing pleural pathology on MDCT.
  
  
  METHODS
  This was a prospective study in which consecutive patients with MDCT for suspected pleural disease on chest radiograph were randomised into two groups. The first group received 150 ml of intravenous contrast at a rate of 2.5 ml s(-1) and the second group received 100 ml at 2 ml s(-1). Images were acquired after a 60 s delay. Hounsfield units of the pleura, thoracic aorta, main pulmonary artery, portal vein and superior mesenteric artery were measured and analysed by two independent readers.
  
  
  RESULTS
  40 patients (20 in each group) who had pleural enhancement on MDCT were included for final analysis. The mean pleural enhancement value was 83 HU (Group A) vs 59 HU (Group B) (p = 0.0004). The mean aortic enhancement was 241 HU (A) vs 141 HU (B) (p<0.0001); main pulmonary artery enhancement was 208 HU (A) vs 139 HU (B) (p<0.0002); portal venous enhancement was 169 HU (A) vs 115 HU (B) (p<0.0001); and the superior mesenteric artery enhancement was 215 HU (A) vs 128 HU (B) (p<0.0001).
  
  
  CONCLUSIONS
  Enhancement of the pleura and major vessels was significantly higher in the group receiving more contrast at a greater infusion rate. This technique of a single scan through the entire pleural surface with a delayed acquisition is promising. When pleural disease is suspected, contrast infusion protocols should be modified to achieve the best results and clinicians should be encouraged to specifically request a "pleural CT".
authors.affiliation: Department of Radiology, Glenfield Hospital, University Hospitals of Leicester, Leicester, UK. drvimalraj@gmail.com
authors.forename: V
authors.initials: V
authors.lastname: Raj
authors.forename: R
authors.initials: R
authors.lastname: Kirke
authors.forename: M J
authors.initials: MJ
authors.lastname: Bankart
authors.forename: J J
authors.initials: JJ
authors.lastname: Entwisle
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000379:methods; D003287:Contrast Media / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D010994:Pleura / Q000098:blood supply / Q000000981:diagnostic imaging*; D010995:Pleural Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011446:Prospective Studies; D011856:Radiographic Image Enhancement; D013902:Radiography, Thoracic / Q000379:methods*; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult
chemical_list: D003287:Contrast Media