Intraarterial CT angiography using ultra low volume of iodine contrast : own experiences

2015
journal article
article
3
dc.abstract.enBACKGROUND: High volume of intravenous contrast in CT-angiography may result in contrast-induced nephropathy. Intraarterial ultra-low volume of contrast medium results in its satisfactory blood concentration with potentially good image quality. The first main purpose was to assess the influence of the method on function of transplanted kidney in patients with impaired graft function. The second main purpose of the study was to evaluate the usefulness of this method for detection of gastrointestinal and head-and-neck haemorrhages. MATERIAL AND METHODS: Between 2010 and 2013 intraarterial CT-angiography was performed in 56 patients, including 28 with chronic kidney disease (CKD). There were three main subgroups: 18 patients after kidney transplantation, 10 patients with gastrointestinal hemorrhage, 8 patients with head-and-neck hemorrhage. Contralateral or ipsilateral inguinal arterial approach was performed. The 4-French vascular sheaths and 4F-catheters were introduced under fluoroscopy. Intraarterial CT was performed using 64-slice scanner. The scanning protocol was as follows: slice thickness 0.625 mm, pitch 1.3, gantry rotation 0.6 sec., scanning delay 1-2 sec. The extent of the study was established on the basis of scout image. In patients with CKD 6-8 mL of Iodixanol (320 mg/mL) diluted with saline to 18-24 mL was administered at a speed of 4-5 mL/s. RESULTS: Vasculature was properly visualized in all patients. In patients with impaired renal function creatinine/eGFR levels remained stable in all but one case. Traditional arteriography failed and CT-angiography demonstrated the site of bleeding in 3 of 10 patients with symptoms of gastrointestinal bleeding (30%). In 8 patients with head-and-neck bleeding CT-angiography did not prove beneficial when compared to traditional arteriography. CONCLUSIONS: 1. Ultra-low contrast intraarterial CT-angiography does not deteriorate the function of transplanted kidneys in patients with impaired graft function. 2. 3D reconstructions allow for excellent visualization of vascular anatomy of renal transplants. 3. Intraarterial CT-angiography is useful for detection of the bleeding site.pl
dc.contributor.authorGarcarek, Jerzypl
dc.contributor.authorKurcz, Jacekpl
dc.contributor.authorGuziński, Maciejpl
dc.contributor.authorBanasik, Mirosławpl
dc.contributor.authorMiś, Marcinpl
dc.contributor.authorGołębiowski, Tomaszpl
dc.date.accessioned2017-07-17T08:59:09Z
dc.date.available2017-07-17T08:59:09Z
dc.date.issued2015pl
dc.date.openaccess0
dc.description.accesstimew momencie opublikowania
dc.description.additionalBibliogr. s. 349pl
dc.description.physical344-349pl
dc.description.versionostateczna wersja wydawcy
dc.description.volume80pl
dc.identifier.doi10.12659/PJR.894050pl
dc.identifier.eissn1899-0967pl
dc.identifier.issn1733-134Xpl
dc.identifier.urihttp://ruj.uj.edu.pl/xmlui/handle/item/42832
dc.languageengpl
dc.language.containerengpl
dc.rightsUdzielam licencji. Uznanie autorstwa - Użycie niekomercyjne - Bez utworów zależnych 3.0 Polska*
dc.rights.licenceCC-BY-NC-ND
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/3.0/pl/legalcode*
dc.share.typeotwarte czasopismo
dc.subject.enangiographypl
dc.subject.endigital subtractionpl
dc.subject.encontrast mediapl
dc.subject.engastrointestinal hemorrhagepl
dc.subject.eninfusionspl
dc.subject.enintra-arterialpl
dc.subject.enkidney transplantationpl
dc.subject.enmultidetector computed tomographypl
dc.subtypeArticlepl
dc.titleIntraarterial CT angiography using ultra low volume of iodine contrast : own experiencespl
dc.title.journalPolish Journal of Radiologypl
dc.typeJournalArticlepl
dspace.entity.typePublication
dc.abstract.enpl
BACKGROUND: High volume of intravenous contrast in CT-angiography may result in contrast-induced nephropathy. Intraarterial ultra-low volume of contrast medium results in its satisfactory blood concentration with potentially good image quality. The first main purpose was to assess the influence of the method on function of transplanted kidney in patients with impaired graft function. The second main purpose of the study was to evaluate the usefulness of this method for detection of gastrointestinal and head-and-neck haemorrhages. MATERIAL AND METHODS: Between 2010 and 2013 intraarterial CT-angiography was performed in 56 patients, including 28 with chronic kidney disease (CKD). There were three main subgroups: 18 patients after kidney transplantation, 10 patients with gastrointestinal hemorrhage, 8 patients with head-and-neck hemorrhage. Contralateral or ipsilateral inguinal arterial approach was performed. The 4-French vascular sheaths and 4F-catheters were introduced under fluoroscopy. Intraarterial CT was performed using 64-slice scanner. The scanning protocol was as follows: slice thickness 0.625 mm, pitch 1.3, gantry rotation 0.6 sec., scanning delay 1-2 sec. The extent of the study was established on the basis of scout image. In patients with CKD 6-8 mL of Iodixanol (320 mg/mL) diluted with saline to 18-24 mL was administered at a speed of 4-5 mL/s. RESULTS: Vasculature was properly visualized in all patients. In patients with impaired renal function creatinine/eGFR levels remained stable in all but one case. Traditional arteriography failed and CT-angiography demonstrated the site of bleeding in 3 of 10 patients with symptoms of gastrointestinal bleeding (30%). In 8 patients with head-and-neck bleeding CT-angiography did not prove beneficial when compared to traditional arteriography. CONCLUSIONS: 1. Ultra-low contrast intraarterial CT-angiography does not deteriorate the function of transplanted kidneys in patients with impaired graft function. 2. 3D reconstructions allow for excellent visualization of vascular anatomy of renal transplants. 3. Intraarterial CT-angiography is useful for detection of the bleeding site.
dc.contributor.authorpl
Garcarek, Jerzy
dc.contributor.authorpl
Kurcz, Jacek
dc.contributor.authorpl
Guziński, Maciej
dc.contributor.authorpl
Banasik, Mirosław
dc.contributor.authorpl
Miś, Marcin
dc.contributor.authorpl
Gołębiowski, Tomasz
dc.date.accessioned
2017-07-17T08:59:09Z
dc.date.available
2017-07-17T08:59:09Z
dc.date.issuedpl
2015
dc.date.openaccess
0
dc.description.accesstime
w momencie opublikowania
dc.description.additionalpl
Bibliogr. s. 349
dc.description.physicalpl
344-349
dc.description.version
ostateczna wersja wydawcy
dc.description.volumepl
80
dc.identifier.doipl
10.12659/PJR.894050
dc.identifier.eissnpl
1899-0967
dc.identifier.issnpl
1733-134X
dc.identifier.uri
http://ruj.uj.edu.pl/xmlui/handle/item/42832
dc.languagepl
eng
dc.language.containerpl
eng
dc.rights*
Udzielam licencji. Uznanie autorstwa - Użycie niekomercyjne - Bez utworów zależnych 3.0 Polska
dc.rights.licence
CC-BY-NC-ND
dc.rights.uri*
http://creativecommons.org/licenses/by-nc-nd/3.0/pl/legalcode
dc.share.type
otwarte czasopismo
dc.subject.enpl
angiography
dc.subject.enpl
digital subtraction
dc.subject.enpl
contrast media
dc.subject.enpl
gastrointestinal hemorrhage
dc.subject.enpl
infusions
dc.subject.enpl
intra-arterial
dc.subject.enpl
kidney transplantation
dc.subject.enpl
multidetector computed tomography
dc.subtypepl
Article
dc.titlepl
Intraarterial CT angiography using ultra low volume of iodine contrast : own experiences
dc.title.journalpl
Polish Journal of Radiology
dc.typepl
JournalArticle
dspace.entity.type
Publication
Affiliations

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