title: Assessment of single-bolus contrast administration technique using hybrid dual-source ECG-gated thoracic and dual-source non-ECG-gated high-pitch abdominopelvic CT acquisitions for procedural planning before transcatheter aortic valve replacement.
abstract: OBJECTIVE
  This study aimed to assess vascular contrast opacification and homogeneity using single-bolus contrast administration with hybrid thoracic and abdominopelvic computed tomographic angiography in patients with severe aortic valve stenosis.
  
  
  METHODS
  Combination electrocardiogram-gated thoracic and dual-source, high-pitch abdominopelvic computed tomographic angiography examinations of 50 patients with severe aortic stenosis between December 2013 and March 2014 were reviewed. Contrast administration was individualized to patient-specific physiology. Image analysis of vascular opacification was obtained and interdependencies of vascular contrast and homogeneity of contrast distribution were assessed.
  
  
  RESULTS
  The mean volume of contrast administered was 106 ± 11.7 mL. Mean attenuation was 371 ± 90.7 Hounsfield units (HU) in the thoracic aorta and 388 ± 95.9 HU in the abdominal aorta. Homogeneous opacification was obtained throughout with coefficient of variation of 11%.
  
  
  CONCLUSIONS
  Procedural planning for transcatheter aortic valve replacement can be achieved using a single-injection bolus contrast protocol in combination with a 2-part multidetector computed tomographic image acquisition technique with optimal opacification of major arterial structures.
authors.affiliation: From the *Department of Radiology, Duke University Medical Center, Durham, NC; †Department of Radiology, University of Virginia Medical Center, Charlottesville, VA; ‡Division of Cardiology, and §Division of Cardiovascular and Thoracic Surgery, Duke University Medical Center, Durham, NC.
authors.forename: Wendy L
authors.initials: WL
authors.lastname: Walker
authors.forename: Daniel T
authors.initials: DT
authors.lastname: Boll
authors.forename: Juliana M
authors.initials: JM
authors.lastname: Bueno
authors.forename: Todd L
authors.initials: TL
authors.lastname: Kiefer
authors.forename: John P
authors.initials: JP
authors.lastname: Vavalle
authors.forename: Jeffrey G
authors.initials: JG
authors.lastname: Gaca
authors.forename: J Kevin
authors.initials: JK
authors.lastname: Harrison
authors.forename: G Chad
authors.initials: GC
authors.lastname: Hughes
authors.forename: Andrew
authors.initials: A
authors.lastname: Wang
authors.forename: Lynne M
authors.initials: LM
authors.lastname: Hurwitz
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging* / Q000601:surgery*; D003287:Contrast Media / Q000008:administration & dosage*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010347:Patient Care Planning; D010388:Pelvis; D011300:Preoperative Care; D012189:Retrospective Studies; D013909:Thorax; D014057:Tomography, X-Ray Computed; D065467:Transcatheter Aortic Valve Replacement
chemical_list: D003287:Contrast Media