Split- Bolus Injection Producing Simultaneous Late Arterial and Portal Venous Phases in CT Enterography: Preliminary Results

被引:4
作者
Boos, Johannes [1 ,2 ]
Fang, Jieming [1 ]
Chingkoe, Christina M. [1 ,3 ]
Perillo, Michele [1 ]
Smith, Martin [1 ]
Raptopoulos, Vassilios [1 ]
Brook, Olga R. [1 ]
机构
[1] Harvard Med Sch, Beth Israel Deaconess Med Ctr, Dept Radiol, 330 Brookline Ave, Boston, MA 02215 USA
[2] Univ Dusseldorf, Med Fac, Dept Diagnost & Intervent Radiol, Dusseldorf, Germany
[3] Univ Toronto, Med Imaging, Toronto, ON, Canada
关键词
contrast material; Crohn disease; CT; CT enterography; split bolus; DUAL-ENERGY CT; INFLAMMATORY-BOWEL-DISEASE; SPECTRAL MULTIDETECTOR CT; DIAGNOSTIC PERFORMANCE; IMAGING TECHNIQUES; CONTRAST AGENT; CROHNS-DISEASE; DOSE REDUCTION; ROW CT; UROGRAPHY;
D O I
10.2214/AJR.17.18034
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
OBJECTIVE. The purpose of this article is to evaluate the image quality and added value of split-bolus contrast agent injection combining late arterial and portal venous phases compared with single-bolus contrast agent injection late arterial phase CT enterography. MATERIALS AND METHODS. Consecutive patients who underwent CT enterography before and after implementation of a single-bolus CT enterography protocol were included. Attenuation and contrast-to-noise ratio (CNR) were assessed by ROI measurements of the bowel wall and arterial and venous structures. Subjective enhancement of the bowel wall (1, arterial; 2, mucosal; 3, transmural; 4, transmural with mucosal hyperenhancement) and bowel abnormalities were assessed by two independent readers. MR enterography examinations, endoscopy reports, and surgery reports within 30 days after CT enterography were used to produce a composite outcome. RESULTS. Sixty-six patients were included in our study: 33 (mean [+/- SD] age, 46.0 +/- 19.8 years) who underwent split-bolus CT enterography and 33 (mean age, 49.9 +/- 19.0 years) who underwent single-bolus CT enterography. Bowel wall attenuation and CNR were higher for split-bolus CT enterography than for single-bolus CT enterography at 120 kVp (enhancement, 98.7 +/- 23.1 HU vs 85.1 +/- 23.3 HU; CNR, 6.4 +/- 2.5 vs 4.4 +/- 2.3; p < 0.01). Subjective ratings of bowel wall enhancement were higher with the split-bolus CT enterography than the single-bolus CT enterography (2.6 +/- 0.8 vs 2.3 +/- 0.6; p < 0.001). Split-bolus CT enterography led to a higher detection rate of mucosal hyperenhancement than did single-bolus CT enterography in patients with active inflammatory bowel disease (100.0% [7/7; 95% CI, 59.0-100.0%] vs 33.3% [2/6; 95% CI, 4.3-77.7%]; p = 0.02), whereas both protocols had a specificity of 100.0% (9/9). CONCLUSION. Split-bolus CT enterography led to improved CNR (47%) compared with single-bolus CT enterography and significantly increased the detection rate of mucosal hyperenhancement in patients with active inflammatory bowel disease.
引用
收藏
页码:1056 / 1063
页数:8
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