Contrast Enhancement in Chest Multidetector Computed Tomography: Intraindividual Comparison of 300 mg/ml versus 400 mg/ml Iodinated Contrast Medium

Behrendt, Florian F.; Plumhans, Cedric; Keil, Sebastian; Mühlenbruch, Georg; Das, Marco; Seidensticker, Peter; Mutscher, Christina; Günther, Rolf W.; Mahnken, Andreas H.

doi:10.1016/j.acra.2008.05.008

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Volume 16, Issue 2 , Pages 144-149, February 2009

Contrast Enhancement in Chest Multidetector Computed Tomography:

Intraindividual Comparison of 300 mg/ml versus 400 mg/ml Iodinated Contrast Medium

Florian F. Behrendt, MD
- Department of Diagnostic Radiology, University Hospital (RWTH) Aachen, Pauwelsstrasse 30, 52057 Aachen, Germany
- Address correspondence to: F.F.B. Department of Diagnostic Radiology, University Hospital (RWTH) Aachen, Pauwelsstrasse 30, 52057 Aachen, Germany
Cedric Plumhans, MD
- Department of Diagnostic Radiology, University Hospital (RWTH) Aachen, Pauwelsstrasse 30, 52057 Aachen, Germany
Sebastian Keil, MD
- Department of Diagnostic Radiology, University Hospital (RWTH) Aachen, Pauwelsstrasse 30, 52057 Aachen, Germany
Georg Mühlenbruch, MD
- Department of Diagnostic Radiology, University Hospital (RWTH) Aachen, Pauwelsstrasse 30, 52057 Aachen, Germany
Marco Das, MD
- Department of Diagnostic Radiology, University Hospital (RWTH) Aachen, Pauwelsstrasse 30, 52057 Aachen, Germany
Peter Seidensticker, MD
- Bayer Schering Pharma AG, Berlin, Germany
Christina Mutscher, PhD
- Institute of Medical Statistics, University Hospital (RWTH) Aachen, Germany
Rolf W. Günther, MD
- Department of Diagnostic Radiology, University Hospital (RWTH) Aachen, Pauwelsstrasse 30, 52057 Aachen, Germany
Andreas H. Mahnken, MD
- Department of Diagnostic Radiology, University Hospital (RWTH) Aachen, Pauwelsstrasse 30, 52057 Aachen, Germany

Received 1 April 2008; accepted 2 May 2008.

Rationale and Objectives

We sought to intraindividually compare intravascular contrast enhancement in multidector computed tomography (MDCT) of the chest using contrast media (CM) containing 300 and 400 mg iodine/ml.

Materials and Methods

Seventy-one patients underwent repeated MDCT scanning of the chest at baseline and follow-up. CM with standard iodine (protocol A: 300 mg iodine/ml; Iopromide 300) and high iodine concentration (protocol B: 400 mg iodine/ml; Iomeprol 400) were used. The iodine delivery rate (1.29 g iodine/s) and total iodine load (37 g iodine) were identical for the two protocols. Contrast enhancement was measured in the right and left ventricles, pulmonary trunk, right and left pulmonary arteries, and ascending and descending aortas. Results were compared using paired t-tests; P values were adjusted using Bonferroni correction (P ≤ .005).

Results

Contrast enhancement values showed no statistically significant differences between the two protocols at all anatomic sites (all P > .005). In the right ventricle, pulmonary trunk, and right and left pulmonary arteries, higher attenuation values for protocol A were detected compared to protocol B (379.0 ± 110.5 vs. 349.8 ± 117.6, 354.5 ± 112.2 vs 330.9 ± 118.3, 348.6 ± 106.0 vs. 321.8 ± 109.9, and 347.9 ± 102.4 vs. 321.0 ± 104.9 HU, respectively). After the lung circulation (left ventricle, ascending aorta, and descending aorta), attenuation values were marginally higher for protocol B. Using both protocols resulted in suitable contrast enhancement with a mean pulmonary attenuation higher than 300 HU.

Conclusions

Using an adapted injection protocol, the administration of 300 and 400 mg iodine CM resulted in a suitable intravascular contrast enhancement in the chest. The use of 400 mg iodine CM does not lead to a statistically significant improvement in contrast enhancement compared to the 300 mg iodine CM.

Key Words: CT, contrast medium, intraindividual comparison, iodine concentration