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Time-resolved Computed Tomography Imaging of the Aorta: A Feasibility Study

Sommer, Wieland H. MD; Clevert, Dirk A. MD; Bamberg, Fabian MD; Helck, Andreas MD; Albrecht, Edda; Reiser, Maximilian F. MD; Becker, Christoph R. MD; Nikolaou, Konstantin MD

Journal of Thoracic Imaging: May 2010 - Volume 25 - Issue 2 - pp 161-167
doi: 10.1097/RTI.0b013e3181d9c9de
Symposium

Purpose: The aim of this study was to test the feasibility and the additional value of time-resolved computed tomography angiography (CTA) of the aorta, using multiple low-dose phases.

Materials and Methods: Twenty-two consecutive patients underwent a time-resolved CTA protocol (TR-CTA) of the aorta, either for follow-up of endovascular aneurysm repair (EVAR) or aortic dissection, using a CT scanner with the possibility of bidirectional table movements for dynamic CT imaging (Siemens Definition AS+; 12 phases, temporal resolution 2.5 s/scan, 80 kVp, 120 mAs/rot, scan range 27 cm, 60 mL; Imeron 400, flow 5.0 mL/s). The patients had previously undergone standard CTA (120 kVp, 100 mL contrast agent). Standard CTA after EVAR and aortic dissection were triphasic and biphasic protocols, respectively. Effective radiation dose and maximum Hounsfield unit values were compared between the TR-CTA and standard CTA. Image quality was rated for TR-CTA.

Results: Fifteen patients underwent TR-CTA for follow-up after EVAR; 4 were examined for follow-up after dissection and 3 for both, that is, aortic dissection treated with an endovascular stent. Mean effective dose of TR-CTA for the scan range of 27 cm (15.3±1.1 mSv) was comparable with the biphasic standard CTA protocols (16.2±2.4 mSv; P=0.29). Triphasic protocols resulted in 23.7±4.9 mSv (P<0.0001). Hounsfield unit values were not significantly different. Most of the examinations (91%) were fully evaluable, whereas 9% were of limited evaluability because of high image noise. None of the examinations was nondiagnostic.

Discussion: TR-CTA consisting of multiple low-dose phases leads to a clear depiction of the angiographic information and is feasible for follow-up after EVAR and aortic dissection. Considering the limited scan range, radiation dose is comparable with the standard biphasic CTA protocol, but dynamic information may provide additional information.

Department of Clinical Radiology, University Hospitals-Grosshadern, Ludwig-Maximilians University, Munich, Germany

This study was supported by Bracco, Italy.

Reprints: Wieland H. Sommer, MD, Department of Clinical Radiology, University of Munich, Grosshadern Campus, Marchioninistr 15, 81377 Munich, Germany (e-mail: wieland.sommer@med.uni-muenchen.de).

© 2010 Lippincott Williams & Wilkins, Inc.