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High-pitch Dual-source Computed Tomography Pulmonary Angiography in Freely Breathing Patients

Bauer, Ralf W. MD; Schell, Boris MD; Beeres, Martin MD; Wichmann, Julian L. MD; Bodelle, Boris MD; Vogl, Thomas J. MD; Kerl, Josef Matthias MD

Journal of Thoracic Imaging:
doi: 10.1097/RTI.0b013e318250067e
Original Articles

Purpose: To investigate pulmonary arterial (PA) enhancement, image noise, and artifacts related to breathing and heart motion in patients with suspected pulmonary embolism.

Materials and Methods: Seventy-six consecutive patients underwent computed tomographic pulmonary angiography (CTPA) in dual-source high-pitch mode (pitch 3.0, 100 kV, 180 mAs, 50 mL contrast material) without breathing commands. PA enhancement, image noise, signal to noise ratio, overall image quality, incidence of total or partial interruption of the contrast column in the PAs, and heart motion-related and breathing-related artifacts of the diaphragm and pulmonary structures were recorded.

Results: Mean central and peripheral PA attenuation was 404±104 and 453±119 HU; mean image noise was 11±2 HU; mean examination time was 0.67±0.09 s; and mean dose-length product was 142±31 mGy cm. There were no motion artifacts of the diaphragm or pulmonary vessels related to breathing or heart motion. There was no case of partial or total interruption of the contrast column in the PA tree. No examination was rated nondiagnostic.

Conclusions: High-pitch dual-source CTPA in freely breathing patients effectively produces images that are free of artifacts related to breathing and cardiac motion. Hence, Valsalva-related artifacts can be eliminated using this technique.

Author Information

Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Frankfurt, Germany

Ralf Bauer and Matthias Kerl are on the speaker’s bureau and clinical consultants of the Siemens AG. No funding was received for this work. The other authors declare no conflicts of interest.

Reprints: Ralf W. Bauer, MD, Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Haus 23C UG, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany (e-mail:

© 2012 Lippincott Williams & Wilkins, Inc.