Optimizing liver contrast in helical liver CT: value of a real-time bolus-triggering technique |
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Authors: | H-P Dinkel M Fieger J Knüpffer R Moll G Schindler |
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Institution: | (1) Department of Diagnostic Radiology, University of Würzburg, Josef-Schneider-Strasse 2, Building 6, D-97080 Würzburg, Germany, DE |
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Abstract: | Optimal liver enhancement during portal venous-phase helical CT is crucial in the detection of parenchymal liver lesions.
In the prospective study reported here we investigated the effects of a real-time bolus-tracking system on mean and maximal
liver enhancement. In 79 patients referred to us for abdominal CT we injected 120 ml of non-ionic contrast (300 mg I/ml) at
a rate of 3 ml/s. After a nonintravenous contrast upper abdominal scan a portal venous phase was performed. In 39 patients
(mean weight 72.6 ± 18.7 kg, range 48–139 kg) real-time bolus tracking was performed using the CARE Bolus software (Siemens,
Erlangen, Germany). The software performs repetitive low-dose test scans in a preselected region of interest and measures
the Hounsfield attenuation and liver enhancement in real-time. After a critical threshold (we selected 31 HU) is surpassed,
the software starts diagnostic spiral scanning. Our control consisted of 40 patients weighing 51–100 kg (mean 73.2 ± 11.1
kg) who were scanned with a fixed, preselected start delay of 80 s. Mean hepatic enhancement was 54.0 ± 9.9 HU (range 33.3–74
HU) in 37 automatically triggered patients, mean peak hepatic enhancement 64.6 ± 12.6 HU (range 42.0–91.8 HU). In 2 patients
of the study group scanning had to be started manually. In the control group with fixed delay mean enhancement was 48.3 ±
9.2 HU (range 33.8–71.6 HU) and peak enhancement 55.5 ± 9.7 HU (range 39.7–81.0 HU). Differences were significant (p < 0.05, Student's t-test). Real-time bolus tracking significantly increased mean hepatic enhancement and may improve portal venous hepatic CT
scanning.
Received 23 October 1997; Revision received 2 February 1998; Accepted 3 February 1998 |
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Keywords: | : Liver CT Contrast enhancement Bolus triggering |
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