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Ultralow contrast medium doses at CT to diagnose pulmonary embolism in patients with moderate to severe renal impairment: a feasibility study.

Kristiansson, Mattias; Geijer, Fredrik LU and Nyman, Ulf LU (2010) In European Radiology 20. p.1321-1330
Abstract
OBJECTIVES: To analyse 80-kVp 16-MDCT in patients with clinically suspected pulmonary embolism (PE) and diminished renal function after a reduction in dose of contrast medium (CM) from 200 to 150 mg I/kg. METHODS: Fifty patients with suspected PE and glomerular filtration rate (GFR) less than 50 mL/min underwent 80-kVp 16-MDCT with 150 mg I/kg. Mean density/image noise (1 standard deviation) was measured in a region of interest in the left pulmonary artery (LPA) and a lower lobe segmental artery (LLSA), and the contrast-to-noise ratio (CNR) was calculated. The values of LPA and LLSA were averaged. RESULTS: Median values/2.5-97.5 percentiles were: age 84/67-96 years, weight 65/43-84 kg, GFR 36/21-45 mL/min, CM dose 9.6/6.4-12 g of iodine,... (More)
OBJECTIVES: To analyse 80-kVp 16-MDCT in patients with clinically suspected pulmonary embolism (PE) and diminished renal function after a reduction in dose of contrast medium (CM) from 200 to 150 mg I/kg. METHODS: Fifty patients with suspected PE and glomerular filtration rate (GFR) less than 50 mL/min underwent 80-kVp 16-MDCT with 150 mg I/kg. Mean density/image noise (1 standard deviation) was measured in a region of interest in the left pulmonary artery (LPA) and a lower lobe segmental artery (LLSA), and the contrast-to-noise ratio (CNR) was calculated. The values of LPA and LLSA were averaged. RESULTS: Median values/2.5-97.5 percentiles were: age 84/67-96 years, weight 65/43-84 kg, GFR 36/21-45 mL/min, CM dose 9.6/6.4-12 g of iodine, PA density 353/164-495 HU and CNR 11/4.4-20. PE incidence was 16%, and 8% and 12% of the examinations were regarded suboptimal by observer 1 and 2, respectively. Density/CNR values were within ranges reported for common 120-kVp MDCT protocols. None of 32 patients with plasma-creatinine follow-up within 1 week experienced a rise of more than 44.2 mumol/L and none of 50 patients had oliguria/anuria or dialysis. None of 40 patients with a negative CT/no anticoagulation had thromboembolism during follow-up. CONCLUSION: 80-kVp MDCT combined with individualised ultralow CM doses may provide satisfactory diagnostic quality, which should be to the benefit of patients at risk of contrast medium-induced nephropathy. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
European Radiology
volume
20
pages
1321 - 1330
publisher
Springer
external identifiers
  • wos:000277200500004
  • pmid:20033693
  • scopus:77952090916
ISSN
0938-7994
DOI
10.1007/s00330-009-1691-0
language
English
LU publication?
yes
id
d48f9ac2-23ab-4537-953f-c46f44a2c95b (old id 1523332)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/20033693?dopt=Abstract
date added to LUP
2010-01-11 14:41:50
date last changed
2018-05-29 12:20:00
@article{d48f9ac2-23ab-4537-953f-c46f44a2c95b,
  abstract     = {OBJECTIVES: To analyse 80-kVp 16-MDCT in patients with clinically suspected pulmonary embolism (PE) and diminished renal function after a reduction in dose of contrast medium (CM) from 200 to 150 mg I/kg. METHODS: Fifty patients with suspected PE and glomerular filtration rate (GFR) less than 50 mL/min underwent 80-kVp 16-MDCT with 150 mg I/kg. Mean density/image noise (1 standard deviation) was measured in a region of interest in the left pulmonary artery (LPA) and a lower lobe segmental artery (LLSA), and the contrast-to-noise ratio (CNR) was calculated. The values of LPA and LLSA were averaged. RESULTS: Median values/2.5-97.5 percentiles were: age 84/67-96 years, weight 65/43-84 kg, GFR 36/21-45 mL/min, CM dose 9.6/6.4-12 g of iodine, PA density 353/164-495 HU and CNR 11/4.4-20. PE incidence was 16%, and 8% and 12% of the examinations were regarded suboptimal by observer 1 and 2, respectively. Density/CNR values were within ranges reported for common 120-kVp MDCT protocols. None of 32 patients with plasma-creatinine follow-up within 1 week experienced a rise of more than 44.2 mumol/L and none of 50 patients had oliguria/anuria or dialysis. None of 40 patients with a negative CT/no anticoagulation had thromboembolism during follow-up. CONCLUSION: 80-kVp MDCT combined with individualised ultralow CM doses may provide satisfactory diagnostic quality, which should be to the benefit of patients at risk of contrast medium-induced nephropathy.},
  author       = {Kristiansson, Mattias and Geijer, Fredrik and Nyman, Ulf},
  issn         = {0938-7994},
  language     = {eng},
  pages        = {1321--1330},
  publisher    = {Springer},
  series       = {European Radiology},
  title        = {Ultralow contrast medium doses at CT to diagnose pulmonary embolism in patients with moderate to severe renal impairment: a feasibility study.},
  url          = {http://dx.doi.org/10.1007/s00330-009-1691-0},
  volume       = {20},
  year         = {2010},
}