title: Low contrast media volume in pre-TAVI CT examinations.
abstract: OBJECTIVE
  To evaluate image quality using reduced contrast media (CM) volume in pre-TAVI assessment.
  
  
  METHODS
  Forty-seven consecutive patients referred for pre-TAVI examination were evaluated. Patients were divided into two groups: group 1 BMI < 28 kg/m(2) (n = 29); and group 2 BMI > 28 kg/m(2) (n = 18). Patients received a combined scan protocol: retrospective ECG-gated helical CTA of the aortic root (80kVp) followed by a high-pitch spiral CTA (group 1: 70 kV; group 2: 80 kVp) from aortic arch to femoral arteries. All patients received one bolus of CM (300 mgI/ml): group 1: volume = 40 ml; flow rate = 3 ml/s, group 2: volume = 53 ml; flow rate = 4 ml/s. Attenuation values (HU) and contrast-to-noise ratio (CNR) were measured at the levels of the aortic root (helical) and peripheral arteries (high-pitch). Diagnostic image quality was considered sufficient at attenuation values > 250HU and CNR > 10.
  
  
  RESULTS
  Diagnostic image quality for TAVI measurements was obtained in 46 patients. Mean attenuation values and CNR (HU ± SD) at the aortic root (helical) were: group 1: 381 ± 65HU and 13 ± 8; group 2: 442 ± 68HU and 10 ± 5. At the peripheral arteries (high-pitch), mean values were: group 1: 430 ± 117HU and 11 ± 6; group 2: 389 ± 102HU and 13 ± 6.
  
  
  CONCLUSIONS
  CM volume can be substantially reduced using low kVp protocols, while maintaining sufficient image quality for the evaluation of aortic root and peripheral access sites.
  
  
  CONCLUSIONS
  • Image quality could be maintained using low kVp scan protocols. • Low kVp protocols reduce contrast media volume by 34-67 %. • Less contrast media volume lowers the risk of contrast-induced nephropathy.
authors.affiliation: Department of Radiology, Maastricht University Medical Center, P. Debyelaan 25, PO Box 5800, 6202 AZ, Maastricht, The Netherlands.|CARIM School for Cardiovascular Diseases, Maastricht University Medical Center, P. Debyelaan 25, PO Box 5800, 6202 AZ, Maastricht, The Netherlands.
authors.forename: Madeleine
authors.initials: M
authors.lastname: Kok
authors.affiliation: Department of Radiology, Maastricht University Medical Center, P. Debyelaan 25, PO Box 5800, 6202 AZ, Maastricht, The Netherlands.
authors.forename: Jakub
authors.initials: J
authors.lastname: Turek
authors.affiliation: Department of Radiology, Maastricht University Medical Center, P. Debyelaan 25, PO Box 5800, 6202 AZ, Maastricht, The Netherlands.|CARIM School for Cardiovascular Diseases, Maastricht University Medical Center, P. Debyelaan 25, PO Box 5800, 6202 AZ, Maastricht, The Netherlands.
authors.forename: Casper
authors.initials: C
authors.lastname: Mihl
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Hospital, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany.
authors.forename: Sebastian D
authors.initials: SD
authors.lastname: Reinartz
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Hospital, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany.
authors.forename: Robin F
authors.initials: RF
authors.lastname: Gohmann
authors.affiliation: Department of Radiology, Maastricht University Medical Center, P. Debyelaan 25, PO Box 5800, 6202 AZ, Maastricht, The Netherlands.
authors.forename: Estelle C
authors.initials: EC
authors.lastname: Nijssen
authors.affiliation: Department of Cardiothoracic Surgery, Maastricht University Medical Center, P. Debyelaan 25, PO Box 5800, 6202 AZ, Maastricht, The Netherlands.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Kats
authors.affiliation: Department of Cardiology, Maastricht University Medical Center MUMC+, P. Debyelaan 25, PO Box 5800, 6202 AZ, Maastricht, The Netherlands.
authors.forename: Vincent G
authors.initials: VG
authors.lastname: van Ommen
authors.affiliation: CARIM School for Cardiovascular Diseases, Maastricht University Medical Center, P. Debyelaan 25, PO Box 5800, 6202 AZ, Maastricht, The Netherlands.|Department of Cardiology, Maastricht University Medical Center MUMC+, P. Debyelaan 25, PO Box 5800, 6202 AZ, Maastricht, The Netherlands.
authors.forename: Bas L J H
authors.initials: BL
authors.lastname: Kietselaer
authors.affiliation: Department of Radiology, Maastricht University Medical Center, P. Debyelaan 25, PO Box 5800, 6202 AZ, Maastricht, The Netherlands.|CARIM School for Cardiovascular Diseases, Maastricht University Medical Center, P. Debyelaan 25, PO Box 5800, 6202 AZ, Maastricht, The Netherlands.
authors.forename: Joachim E
authors.initials: JE
authors.lastname: Wildberger
authors.affiliation: Department of Radiology, Maastricht University Medical Center, P. Debyelaan 25, PO Box 5800, 6202 AZ, Maastricht, The Netherlands. m.das@mumc.nl.|CARIM School for Cardiovascular Diseases, Maastricht University Medical Center, P. Debyelaan 25, PO Box 5800, 6202 AZ, Maastricht, The Netherlands. m.das@mumc.nl.|Maastricht University Medical Center, P. Debyelaan 25, PO Box 5800, 6202 AZ, Maastricht, The Netherlands. m.das@mumc.nl.
authors.forename: Marco
authors.initials: M
authors.lastname: Das
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta / Q000000981:diagnostic imaging*; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging*; D003287:Contrast Media / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D065467:Transcatheter Aortic Valve Replacement / Q000379:methods*
chemical_list: D003287:Contrast Media
keywords: Contrast induced nephropathy; Contrast media; Diagnostic imaging; Multi detector-row CT; Transcatheter aortic valve implantation