Contrast Dynamics during CT Pulmonary Angiogram

Analysis of an Inspiration Associated Artifact

Marc Gosselin, Ulrich A. Rassner, Sheldon L. Thieszen, Jinnah Phillips, Allison Oki

Research output: Contribution to journalArticle

69 Citations (Scopus)

Abstract

Objective: Several artifacts have been observed during contrast-enhanced CT of the pulmonary arteries. We describe a physiological artifact caused by a transient interruption of the contrast column in the pulmonary arteries associated with inspiration immediately prior to imaging. This results from a variable inflow of unopacified blood from the inferior vena cava (IVC). Materials and Methods: From 327 consecutive pulmonary CT-angiograms, all performed on a single detector scanner at 3mm collimation (1.5mm incremental reconstruction), 50 positive studies, 46 indeterminate studies, and 33 negative studies (129 exams) were retrospectively reviewed by a blinded observer to determine the frequency of the described contrast interruption, its severity (mild, moderate, or severe), and its possible contribution to misinterpretation of studies. The numerical change in Hounsfield units was assigned within the right ventricular chamber for each examination to correlate with the subjective evaluation of severity. Statistical significance was determined with P = 0.05%. Results: The artifact was present in 48 (37.2%) of the 129 evaluated studies. It was greater in frequency (50.0%) with the negative studies. The presence was 25% with positive studies and 36.7% with indeterminate exams. The interruption was more often mild (150 HU change) and the other study demonstrated a moderate (100-150 HU) interruption of contrast opacification. Conclusions: During inspiration, there is a variable increase in unopacified venous blood from the IVC, briefly diluting the contrast column entering from the SVC. This interruption is common, though usually mild in severity. However, a short severe interruption of vascular opacification can lead to misinterpretation as a pulmonary embolus or contribute to an indeterminate examination.

Original languageEnglish (US)
Pages (from-to)1-7
Number of pages7
JournalJournal of Thoracic Imaging
Volume19
Issue number1
DOIs
StatePublished - Jan 2004

Fingerprint

Artifacts
Angiography
Inferior Vena Cava
Lung
Pulmonary Artery
Embolism
Blood Vessels

Keywords

  • Artifacts
  • CT pulmonary angiogram

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Pulmonary and Respiratory Medicine
  • Radiological and Ultrasound Technology

Cite this

Contrast Dynamics during CT Pulmonary Angiogram : Analysis of an Inspiration Associated Artifact. / Gosselin, Marc; Rassner, Ulrich A.; Thieszen, Sheldon L.; Phillips, Jinnah; Oki, Allison.

In: Journal of Thoracic Imaging, Vol. 19, No. 1, 01.2004, p. 1-7.

Research output: Contribution to journalArticle

Gosselin, Marc ; Rassner, Ulrich A. ; Thieszen, Sheldon L. ; Phillips, Jinnah ; Oki, Allison. / Contrast Dynamics during CT Pulmonary Angiogram : Analysis of an Inspiration Associated Artifact. In: Journal of Thoracic Imaging. 2004 ; Vol. 19, No. 1. pp. 1-7.
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