Dynamic CTA in Native Kidneys Using a Multiphase CT Protocol—Potential of Significant Reduction of Contrast Medium

Publication date: Available online 12 March 2018
Source:Academic Radiology
Author(s): Margarita Braunagel, Florian Ortner, Ulf Schönermarck, Antje Habicht, Andreas Schindler, Manfred Stangl, Frederik F. Strobl, Maximilian Reiser, Dirk A. Clevert, Christoph Trumm, Andreas Helck
Rationale and ObjectiveThe objective of this study was to assess an optimized renal multiphase computed tomography angiography (MP-CTA) protocol regarding reduction of contrast volume.Materials and MethodsThirty patients underwent MP-CTA (12 phases, every 3.5 seconds, 80 kV/120 mAs) using 30 mL of contrast medium. The quality of MP-CTA was assessed quantitatively measuring vessel attenuation, image noise, and contrast-to-noise ratio. MP-CTA was evaluated qualitatively regarding depiction of vessels, cortex differentiation, and motion artifacts (grades 1–4, 1 = best). Mean effective radiation dose was registered. Results were compared to standard renal computed tomography angiography (CTA) (80 mL). Student t test was applied, if variables followed normal distribution. For other variables, nonparametric Mann-Whitney U test was used.ResultsAll acquisitions were successfully performed, and no patient had to be excluded from the study. MP-CTA enabled high attenuation (aorta: 503 ± 91 HU, renal arteries: 450 ± 73 HU/456 ± 72 HU) at adequate image noise (13.7 ± 1.5) and good contrast-to-noise ratio (34.2 ± 10.2). Good attenuation of renal veins was observed (286 ± 43 HU/282 ± 42 HU). Arterial enhancement was significantly higher compared to renal CTA (aorta: 396 ± 90 HU, renal arteries: 331 ± 74 HU/333 ± 80 HU; P < .001). MP-CTA protocol enabled good image quality of renal arteries (1.5 ± 0.6) and veins (1.7 ± 0.6). Cortex differentiation and motion artifacts were ranked 1.8 ± 0.8 and 1.6 ± 0.8. The mean effective radiation dose was 9 mSv (MP-CTA).ConclusionsCompared to standard renal CTA, the renal MP-CTA enabled the significant reduction of contrast volume and simultaneously provided a significantly higher arterial attenuation.



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