CT Angiography in the Lower Extremity Peripheral Artery Disease Feasibility of an Ultra-Low Volume Contrast Media Protocol

摘要

Purpose The ALARA principle is not only relevant for effective dose (ED) reduction, but also applicable for contrast media (CM) management. Therefore, the aim was to evaluate the feasibility of an ultra-low CM protocol in the assessment of peripheral artery disease (PAD). Materials and methods Fifty PAD patients were scanned on third-generation dual-source computed tomography, from diaphragm to the forefoot, as follows: tube voltage: 70?kV, reference effective tube current: 90?mAs, collimation: 192?×?2?×?0.6?mm, with individualized acquisition timing. The protocol ED (mSv) was quantified with dedicated software. CM protocol consisted of 15?ml test bolus and 30?ml main bolus (300?mgI/ml) injected at 5?ml/s, followed by a 40?ml saline chaser at the same flow rate. Aorto-popliteal bolus transit time was used to calculate the overall acquisition time and delay. Objective (hounsfield units—HU; contrast-to-noise ratio—CNR) and subjective image quality (four-point Likert score) were assessed at different anatomical regions from the aorta down to the forefoot. Results Mean attenuation values were exceeding 250?HU from aorta down to the anterior tibial artery with CNR?