Iodine Concentration and Optimization in Computed Tomography Angiography Current Issues
Iodine Concentration and Optimization in Computed Tomography Angiography Current Issues
复制标题
DOI：
10.1097/rli.0000000000000283
复制
发表时间：
2016-12-01
影响因子：
6.7
通讯作者：
Gabelloni, Michela
中科院分区：
文献类型：
--
作者：
Faggioni, Lorenzo;Gabelloni, Michela
计算机断层扫描（CT）技术在最近的过去发生了巨大的变化，深刻地改变了这种诊断方式的面貌。自螺旋单层和多层CT的早期以来，CT血管造影术（CTA）一直是在扫描技术和造影剂（CM）注射协议方面技术要求最高的应用之一，因为需要在有限的时间内采集大量的高分辨率数据，对应于动脉系统的峰值对比度增强。碘浓度是CTA中动脉增强的主要决定因素之一，目前用于血管内给药的低渗和等渗非离子CM仍有少数分子，但不同碘浓度的范围相对较宽。这使得有机会根据患者特征、CT技术和CM功能等多个因素优化CTA协议，以最大限度地提高CTA检查的诊断率，同时考虑患者安全性并避免不必要的额外成本。我们的目的是从改善患者护理的角度，同时最大限度地减少碘化CM和电离辐射的总体暴露，提供关于碘浓度变化如何影响CTA性能的现有证据的最新概述，特别是使用最先进的CT和高压注射器技术。
Computed tomography (CT) technology has seen a dramatic evolution in the recent past that has deeply changed the face of this diagnostic modality. Since the early days of helical single-slice and then multislice CT, CT angiography (CTA) has been one of the most technically demanding applications, both in terms of scanning technique and contrast medium (CM) injection protocol, due to the need to acquire a large amount of high-resolution data over a limited period corresponding to the peak contrast enhancement of the arterial system. Iodine concentration is one of the main determinants of arterial enhancement in CTA, and current low-osmolar and iso-osmolar nonionic CM for intravascular administration still come in a handful of molecules, but a relatively wide range of different iodine concentrations. This gives the opportunity to optimize CTA protocols as a function of several factors such as patient characteristics, CT technology, and CM features in an attempt to maximize the diagnostic yield of CTA examinations while considering patient safety and avoiding unnecessary extra costs. Our aim is to provide an up-to-date overview of the existing evidence on how changing iodine concentration can have an impact on CTA performance, especially with the use of state-of-the-art CT and power injector technology, in the perspective of improving patient care while minimizing overall exposure to iodinated CM and ionizing radiation.