title: Carotid and cerebral CT angiography using low volume of iodinated contrast material and low tube voltage.
abstract: OBJECTIVE
  To evaluate image quality of carotid computed tomography angiography (CTA) using a low voltage (80kV) and low amount of iodinated contrast material.
  
  
  METHODS
  A total of 101 patients referred for carotid CTA were randomly assigned to receive a specific protocol. In group A patients received intravenous administration of contrast material at a dose of 1mL/kg and CTA examinations were performed at 100kV. In group B, patients received intravenous administration of contrast material at a dose of 0.5mL/kg and CTA examinations were performed at 80kV. The same nonionic iodinated contrast material containing 370mg of iodine per mL was used in both groups. Attenuation values were measured from the center of specific arterial segments using regions of interest. Attenuation values above 300HU were accepted as significant. Institutional review board approval was obtained.
  
  
  RESULTS
  A total of 50 patients were included in group A (38 men, 12 women; mean age, 63.56 years±13.18 [SD]) and 51 patients in group B (33 men, 18 women; mean age, 59.60 years±16.63 [SD]). A total of 1615 arterial segments (1515 common carotid artery-middle cerebral artery and 101 aortic arches) were analyzed. Venous contamination was not observed in either group. The mean attenuation values of all arterial segments in both groups were greater than 300HU. Mean arterial attenuation value in group B (499.22HU±97.25 [SD]) was significantly greater than in group A (374.36HU±73.79 [SD]) (P<0.01). Hemodynamically significant stenosis (grade III stenosis or >70%) was detected in 2 segments in group A and in 3 segments in group B, while grade IV stenosis (occlusion) was detected in 2 segments in group B. Distal common carotid artery dissection was detected in 1 patient and aortic dissection was detected in 1 patient in group B. Total dose-length product (DLP) value was significantly greater in group A (225.74mGy·cm±21.80 [SD]) than in group B (116.60mGy·cm±21.22 [SD]) (P<0.01). The mean tube current was similar in group A (2013.11mAs±195.92 [SD]) and in group B (2096.64 mAs±309.03 [SD]) (P<0.05).
  
  
  CONCLUSIONS
  Carotid and cerebral CTA examinations using 128-section CT can be successfully obtained using an imaging protocol that combines low voltage and 50% reduction in the volume of iodinated contrast material. This provides good image quality with low radiation dose.
authors.affiliation: Department of Radiology, Faculty of Medicine, Süleyman Demirel University, 32260 Isparta, Turkey. Electronic address: drkayan32@hotmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Kayan
authors.affiliation: Department of Radiology, Faculty of Medicine, Süleyman Demirel University, 32260 Isparta, Turkey. Electronic address: demhakan@yahoo.com.
authors.forename: H
authors.initials: H
authors.lastname: Demirtas
authors.affiliation: Department of Cardiology, Faculty of Medicine, Süleyman Demirel University, 32260 Isparta, Turkey. Electronic address: dryasinturker@hotmail.com.
authors.forename: Y
authors.initials: Y
authors.lastname: Türker
authors.affiliation: Clinic of Chest Diseases, Isparta State Hospital, Isparta, Turkey. Electronic address: fnurkayan@hotmail.com.
authors.forename: F
authors.initials: F
authors.lastname: Kayan
authors.affiliation: Department of Radiology, Faculty of Medicine, Süleyman Demirel University, 32260 Isparta, Turkey. Electronic address: dr_gursel15@hotmail.com.
authors.forename: G
authors.initials: G
authors.lastname: Çetinkaya
authors.affiliation: Department of Radiology, Faculty of Medicine, Süleyman Demirel University, 32260 Isparta, Turkey. Electronic address: raddrkara38@hotmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Kara
authors.affiliation: Department of Radiology, Faculty of Medicine, Süleyman Demirel University, 32260 Isparta, Turkey. Electronic address: aorhancelik@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Orhan Çelik
authors.affiliation: Department of Radiology, Faculty of Medicine, Süleyman Demirel University, 32260 Isparta, Turkey. Electronic address: ayseumul@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Umul
authors.affiliation: Department of Radiology, Faculty of Medicine, Süleyman Demirel University, 32260 Isparta, Turkey. Electronic address: droyilmazrad@hotmail.com.
authors.forename: Ö
authors.initials: Ö
authors.lastname: Yılmaz
authors.affiliation: Department of Radiology, Faculty of Medicine, Süleyman Demirel University, 32260 Isparta, Turkey. Electronic address: aykutraktas@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Recep Aktaş
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002339:Carotid Arteries / Q000000981:diagnostic imaging*; D002533:Cerebral Angiography / Q000379:methods*; D000072226:Computed Tomography Angiography / Q000379:methods*; D003287:Contrast Media / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D007262:Infusions, Intravenous; D007472:Iohexol / Q000008:administration & dosage / Q000031:analogs & derivatives*; D008297:Male; D008875:Middle Aged; D011829:Radiation Dosage; D011856:Radiographic Image Enhancement / Q000379:methods*; D055815:Young Adult
chemical_list: D003287:Contrast Media; D007472:Iohexol; C038192:iopromide
keywords: CT angiography; Carotid artery; Dose reduction; Low contrast material; Low tube voltage