TY - JOUR
T1 - Contrast opacification on thoracic CT angiography
T2 - challenges and solutions
AU - Chaturvedi, Abhishek
AU - Oppenheimer, Daniel
AU - Rajiah, Prabhakar
AU - Kaproth-Joslin, Katherine A.
AU - Chaturvedi, Apeksha
N1 - Publisher Copyright:
© 2016, The Author(s).
PY - 2017/2/1
Y1 - 2017/2/1
N2 - Contrast flow and enhancement patterns seen on thoracic CT angiography (CTA) can often be challenging and may often reveal more than is immediately apparent. A non-diagnostic CTA following the initial contrast injection can be secondary to many causes; these include both extrinsic factors, such as injection technique/equipment failure (iv cannula, power injector), and intrinsic, patient-related factors. Contrast pressure and flow graphs often contain useful information regarding the etiology of a non-diagnostic scan. Understanding these graphs will help the radiologist plan a repeat contrast injection to overcome the deficiencies of the first injection and thus obtain a diagnostic scan. The current review article outlines normal and abnormal intravenous contrast dynamics, discusses how to recognize etiologies of non-diagnostic scans, and ultimately addresses techniques to overcome obstacles towards obtaining normal contrast opacification of the target vessel. In addition, there are some life-threatening findings, which unless sought for, may remain hidden in plain sight. Key Points • Using contrast enhancement and flow patterns to identify the cause of a non-diagnostic CTA. • Recognize life threatening causes of altered contrast dynamics such as cardiac asystole. • Non-target vessel opacification may hold key to underlying pathophysiology.
AB - Contrast flow and enhancement patterns seen on thoracic CT angiography (CTA) can often be challenging and may often reveal more than is immediately apparent. A non-diagnostic CTA following the initial contrast injection can be secondary to many causes; these include both extrinsic factors, such as injection technique/equipment failure (iv cannula, power injector), and intrinsic, patient-related factors. Contrast pressure and flow graphs often contain useful information regarding the etiology of a non-diagnostic scan. Understanding these graphs will help the radiologist plan a repeat contrast injection to overcome the deficiencies of the first injection and thus obtain a diagnostic scan. The current review article outlines normal and abnormal intravenous contrast dynamics, discusses how to recognize etiologies of non-diagnostic scans, and ultimately addresses techniques to overcome obstacles towards obtaining normal contrast opacification of the target vessel. In addition, there are some life-threatening findings, which unless sought for, may remain hidden in plain sight. Key Points • Using contrast enhancement and flow patterns to identify the cause of a non-diagnostic CTA. • Recognize life threatening causes of altered contrast dynamics such as cardiac asystole. • Non-target vessel opacification may hold key to underlying pathophysiology.
KW - CT angiography
KW - Cardiac asystole
KW - Contrast dynamics
KW - ECMO
KW - Non-diagnostic CTA
UR - http://www.scopus.com/inward/record.url?scp=85010692154&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85010692154&partnerID=8YFLogxK
U2 - 10.1007/s13244-016-0524-3
DO - 10.1007/s13244-016-0524-3
M3 - Review article
C2 - 27858323
AN - SCOPUS:85010692154
SN - 1869-4101
VL - 8
SP - 127
EP - 140
JO - Insights into Imaging
JF - Insights into Imaging
IS - 1
ER -