title: Contrast-enhanced angiographic cone-beam computed tomography without pre-diluted contrast medium.
abstract: BACKGROUND
  Contrast-enhanced cone-beam computed tomography (CBCT) has been introduced and accepted as a useful technique to evaluate delicate vascular anatomy and neurovascular stents. Current protocol for CBCT requires quantitative dilution of contrast medium to obtain adequate quality images. Here, we introduce simple methods to obtain contrast-enhanced CBCT without quantitative contrast dilution.
  
  
  METHODS
  A simple experiment was performed to estimate the change in flow rate in the internal carotid artery during the procedure. Transcranial doppler (TCD) was used to evaluate the velocity change before and after catheterization and fluid infusion. In addition, 0.3 cm(3)/s (n = 3) and 0.2 cm(3)/s (n = 7) contrast infusions were injected and followed by saline flushes using a 300 mmHg pressure bag to evaluate neurovascular stent and host arteries.
  
  
  RESULTS
  Flow velocities changed -15 ± 6.8 % and +17 ± 5.5 % from baseline during catheterization and guiding catheter flushing with a 300 mmHg pressure bag, respectively. Evaluation of the stents and vascular structure was feasible using this technique in all patients. Quality assessment showed that the 0.2 cm(3)/s contrast infusion protocol was better for evaluating the stent and host artery.
  
  
  CONCLUSIONS
  Contrast-enhanced CBCT can be performed without quantitative contrast dilution. Adequate contrast dilution can be achieved with a small saline flush and normal blood flow.
authors: Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, South Korea.
authors: K I
authors: KI
authors: Jo
authors: Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, South Korea.
authors: S R
authors: SR
authors: Kim
authors: Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, South Korea.
authors: J H
authors: JH
authors: Choi
authors: Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, South Korea.
authors: K H
authors: KH
authors: Kim
authors: Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, South Korea. pyoung.jeon@samsung.com.
authors: P
authors: P
authors: Jeon
mesh_terms: D000792:Angiography / Q000379:methods*; D001783:Blood Flow Velocity; D002341:Carotid Artery Thrombosis / Q000000981:diagnostic imaging* / Q000601:surgery; D054893:Cone-Beam Computed Tomography / Q000379:methods*; D003287:Contrast Media / Q000737:chemistry*; D006801:Humans; D011856:Radiographic Image Enhancement / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media
keywords: Cone-beam computed tomography; Contrast-enhanced; Flat panel; Stent