title: Contrast Enhancement of the Right Ventricle during Coronary CT Angiography--Is It Necessary?
abstract: OBJECTIVE
  It is unclear if prolonged contrast media injection, to improve right ventricular visualization during coronary CT angiography, leads to increased detection of right ventricle pathology. The purpose of this study was to evaluate right ventricle enhancement and subsequent detection of right ventricle disease during coronary CT angiography.
  
  
  METHODS
  472 consecutive patients referred for screening coronary CT angiography were retrospectively evaluated. Every patient underwent multidetector-row CT of the coronary arteries: 128x 0.6mm coll., 100-120kV, rot. time 0.28s, ref. mAs 350 and received an individualized (P3T) contrast bolus injection of iodinated contrast medium (300 mgI/ml). Patient data were analyzed to assess right ventricle enhancement (HU) and right ventricle pathology. Image quality was defined good when right ventricle enhancement >200HU, moderate when 140-200HU and poor when <140HU.
  
  
  RESULTS
  Good image quality was found in 372 patients, moderate in 80 patients and poor in 20 patients. Mean enhancement of the right ventricle cavity was 268HU±102. Patients received an average bolus of 108±24 ml at an average peak flow rate of 6.1±2.2 ml/s. In only three out of 472 patients (0.63%) pathology of the right ventricle was found (dilatation) No other right ventricle pathology was detected.
  
  
  CONCLUSIONS
  Right ventricle pathology was detected in three out of 472 patients; the dilatation observed in these three cases may have been picked up even without dedicated enhancement of the right ventricle. Based on our findings, right ventricle enhancement can be omitted during screening coronary CT angiography.
authors.affiliation: Department of Radiology, Maastricht University Medical Center, Maastricht, The Netherlands; CARIM Cardio Vascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Madeleine
authors.initials: M
authors.lastname: Kok
authors.affiliation: Department of Radiology, Maastricht University Medical Center, Maastricht, The Netherlands; CARIM Cardio Vascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands; Department of Cardiology, Maastricht University Medical Center, Maastricht, the Netherlands.
authors.forename: Bas L J H
authors.initials: BL
authors.lastname: Kietselaer
authors.affiliation: Department of Radiology, Maastricht University Medical Center, Maastricht, The Netherlands; CARIM Cardio Vascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Casper
authors.initials: C
authors.lastname: Mihl
authors.affiliation: CARIM Cardio Vascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands; Department of Cardiology, Maastricht University Medical Center, Maastricht, the Netherlands.
authors.forename: Sibel
authors.initials: S
authors.lastname: Altintas
authors.affiliation: Department of Radiology, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Estelle C
authors.initials: EC
authors.lastname: Nijssen
authors.affiliation: Department of Radiology, Maastricht University Medical Center, Maastricht, The Netherlands; CARIM Cardio Vascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Joachim E
authors.initials: JE
authors.lastname: Wildberger
authors.affiliation: Department of Radiology, Maastricht University Medical Center, Maastricht, The Netherlands; CARIM Cardio Vascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Marco
authors.initials: M
authors.lastname: Das
mesh_terms: D000368:Aged; D003287:Contrast Media / Q000008:administration & dosage*; D017023:Coronary Angiography / Q000379:methods*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D007275:Injections, Intravenous / Q000379:methods; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media