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Questions and Answers
What is a common indication for IV enhancement in thoracic CT?
What is a common indication for IV enhancement in thoracic CT?
- General thoracic work
- Lung cancer staging (correct)
- Lung cancer diagnosis
- Cardiac evaluation
What factor influences IV enhancement in thoracic CT?
What factor influences IV enhancement in thoracic CT?
- Patient's medical history
- Patient's allergy to iodine
- Patient's body size (correct)
- Patient's age
What is the recommended rate of injection for general thoracic work?
What is the recommended rate of injection for general thoracic work?
- 4 mL s−1
- 2 mL s−1
- 3 mL s−1
- 2.5 mL s−1 (correct)
Why was it necessary to redesign contrast medium administration protocols?
Why was it necessary to redesign contrast medium administration protocols?
What is the purpose of automated bolus triggering?
What is the purpose of automated bolus triggering?
What is a possible consequence of deep inspiration during CTPA?
What is a possible consequence of deep inspiration during CTPA?
What is the recommended volume of contrast medium for general thoracic work?
What is the recommended volume of contrast medium for general thoracic work?
What is the benefit of ‘triple-rule-out’ CT?
What is the benefit of ‘triple-rule-out’ CT?
The iodine concentration of the contrast medium is the only factor that influences IV enhancement in thoracic CT.
The iodine concentration of the contrast medium is the only factor that influences IV enhancement in thoracic CT.
A 100 mL volume of 150 mg mL−1 of iodine is recommended for CTPA.
A 100 mL volume of 150 mg mL−1 of iodine is recommended for CTPA.
DECT technology has reduced the need for IV enhancement in thoracic CT.
DECT technology has reduced the need for IV enhancement in thoracic CT.
The use of automated triggering mechanisms is recommended for general thoracic work.
The use of automated triggering mechanisms is recommended for general thoracic work.
The primary purpose of reducing the dose of contrast agent is to minimize the risk of allergic reactions.
The primary purpose of reducing the dose of contrast agent is to minimize the risk of allergic reactions.
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Study Notes
IV Enhancement in Thoracic CT
- IV enhancement is only required in thoracic CT for specific indications, including lung cancer staging, CT pulmonary angiography (CTPA), CT coronary angiography (CTCA), and aortic evaluation.
Factors Influencing IV Enhancement
- Patient factors: body size (measured by body mass index and body surface area), and cardiac output
- Contrast medium factors: iodine delivery rate (dependent on iodine concentration, injected volume, and rate of injection)
- Timing of acquisition: influenced by automated bolus triggering, test bolus, or set delay to initiate CT data acquisition
- Changes in respiration: suboptimal pulmonary artery opacification in CTPA on deep inspiration due to various suggested mechanisms
Single-Detector CT Contrast Medium Administration
- Recommended protocol: 100 mL of 150 mg mL−1 of iodine injected at a rate of 2.5 mL s−1 after a 25-second delay for general thoracic work
- Recommended protocol for CTPA: 120 to 140 mL of 240 to 300 mg mL−1 of iodine injected at a rate of 3 to 4 mL s−1, with either a fixed delay or automated triggering mechanisms
Changes in Contrast Medium Administration Protocols
- Caused by:
- Reduced acquisition time due to MDCT
- Newer technology, such as DECT
- Need to reduce contrast agent dose to minimize potential nephrotoxicity
- Increasing feasibility of ‘triple-rule-out’ CT for simultaneous evaluation of coronary arteries, pulmonary arteries, aorta, and other intrathoracic abnormalities in patients with acute chest pain
IV Enhancement in Thoracic CT
- IV enhancement is only required in thoracic CT for specific indications, including lung cancer staging, CT pulmonary angiography (CTPA), CT coronary angiography (CTCA), and aortic evaluation.
Factors Influencing IV Enhancement
- Patient factors: body size (measured by body mass index and body surface area), and cardiac output
- Contrast medium factors: iodine delivery rate (dependent on iodine concentration, injected volume, and rate of injection)
- Timing of acquisition: influenced by automated bolus triggering, test bolus, or set delay to initiate CT data acquisition
- Changes in respiration: suboptimal pulmonary artery opacification in CTPA on deep inspiration due to various suggested mechanisms
Single-Detector CT Contrast Medium Administration
- Recommended protocol: 100 mL of 150 mg mL−1 of iodine injected at a rate of 2.5 mL s−1 after a 25-second delay for general thoracic work
- Recommended protocol for CTPA: 120 to 140 mL of 240 to 300 mg mL−1 of iodine injected at a rate of 3 to 4 mL s−1, with either a fixed delay or automated triggering mechanisms
Changes in Contrast Medium Administration Protocols
- Caused by:
- Reduced acquisition time due to MDCT
- Newer technology, such as DECT
- Need to reduce contrast agent dose to minimize potential nephrotoxicity
- Increasing feasibility of ‘triple-rule-out’ CT for simultaneous evaluation of coronary arteries, pulmonary arteries, aorta, and other intrathoracic abnormalities in patients with acute chest pain
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