CT angiography with 15 mL contrast material injection on time-resolved imaging for endovascular abdominal aortic aneurysm repair.
PURPOSE
To assess the utility of whole-aorta CT angiography (CTA) with 15 mL contrast material (CM) on time-resolved imaging for endovascular abdominal aortic repair (EVAR).


METHODS
Twenty-six patients with a high-risk of post-contrast acute kidney injury (PC-AKI) underwent CTA with 15 mL CM using temporal maximum intensity projection (tMIP-CTA) generated from time-resolved imaging. The aortoiliac CT values were measured. Two observers measured the arterial diameters in unenhanced CT and tMIP-CTA images, and image quality was evaluated on a 5-point scale. The presence of the accessory renal artery, inferior mesenteric artery (IMA) occlusion, and instructions for use (IFU) of EVAR were evaluated.


RESULTS
CT examinations were successfully performed, and no patients developed PC-AKI. The mean CT values of the whole aorta were 267.5 ± 51.4 HU, which gradually decreased according to the distal levels of the aorta. Bland-Altman analysis revealed excellent agreement for the external arterial diameter measurements between unenhanced CT and tMIP-CTA. Excellent interobserver agreement was achieved for the measurements of the external (ICCs, 0.910-0.992) and internal arterial diameters (ICCs, 0.895-0.993). Excellent or good overall image quality was achieved in 24 (92 %) patients. The presence of the accessory renal artery, IMA occlusion and the assessment of IFU were in 100 % agreement. Multivariate analysis revealed aortic volume as the most significant independent factor associated with strong aortic enhancement (p = 0.004).


CONCLUSIONS
Whole-aorta tMIP-CTA on time-resolved imaging is useful for maintaining contrast enhancement and image quality for EVAR planning, and can substantially reduce the amount of CM.
['Horinouchi|Hiroki|H|', 'Sofue|Keitaro|K|', 'Nishii|Tatsuya|T|', 'Maruyama|Koji|K|', 'Sasaki|Koji|K|', 'Gentsu|Tomoyuki|T|', 'Ueshima|Eisuke|E|', 'Okada|Takuya|T|', 'Yamaguchi|Masato|M|', 'Sugimoto|Koji|K|', 'Murakami|Takamichi|T|']
D000368:Aged D000369:Aged, 80 and over D001012:Aorta, Abdominal D017544:Aortic Aneurysm, Abdominal D000072226:Computed Tomography Angiography D003287:Contrast Media D057510:Endovascular Procedures D005260:Female D015577:Geriatric Assessment D006801:Humans D008297:Male D011856:Radiographic Image Enhancement D012189:Retrospective Studies
Abdominal aortic aneurysm Contrast media Endovascular procedures Multidetector computed tomography