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Multidetector CT Imaging Of Pleura: Comparison Of Two Contrast Infusion Protocols.

V. Raj, R. Kirke, M. Bankart, J. Entwisle
Published 2011 · Medicine

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OBJECTIVES Imaging of the pleura by multidetector CT (MDCT) can be challenging. There is no clear evidence or guidelines on contrast infusion parameters for imaging pleura. We compared two contrast protocols for assessing pleural pathology on MDCT. METHODS This was a prospective study in which consecutive patients with MDCT for suspected pleural disease on chest radiograph were randomised into two groups. The first group received 150 ml of intravenous contrast at a rate of 2.5 ml s(-1) and the second group received 100 ml at 2 ml s(-1). Images were acquired after a 60 s delay. Hounsfield units of the pleura, thoracic aorta, main pulmonary artery, portal vein and superior mesenteric artery were measured and analysed by two independent readers. RESULTS 40 patients (20 in each group) who had pleural enhancement on MDCT were included for final analysis. The mean pleural enhancement value was 83 HU (Group A) vs 59 HU (Group B) (p = 0.0004). The mean aortic enhancement was 241 HU (A) vs 141 HU (B) (p<0.0001); main pulmonary artery enhancement was 208 HU (A) vs 139 HU (B) (p<0.0002); portal venous enhancement was 169 HU (A) vs 115 HU (B) (p<0.0001); and the superior mesenteric artery enhancement was 215 HU (A) vs 128 HU (B) (p<0.0001). CONCLUSION Enhancement of the pleura and major vessels was significantly higher in the group receiving more contrast at a greater infusion rate. This technique of a single scan through the entire pleural surface with a delayed acquisition is promising. When pleural disease is suspected, contrast infusion protocols should be modified to achieve the best results and clinicians should be encouraged to specifically request a "pleural CT".
This paper references
10.1148/RADIOLOGY.208.1.9646815
Unsuspected pulmonary embolism: prospective detection on routine helical CT scans.
M. Gosselin (1998)
10.1038/sj.bjc.6690105
The European mesothelioma epidemic
J. Peto (1999)
10.1016/j.athoracsur.2007.11.064
Rate of thromboembolic events in mesothelioma.
D. Nguyen (2008)
10.1148/RADIOL.2301021008
Effect of contrast material injection duration and rate on aortic peak time and peak enhancement at dynamic CT involving injection protocol with dose tailored to patient weight.
K. Awai (2004)
10.2214/AJR.184.1.01840264
Incidental detection of pulmonary emboli on routine MDCT of the chest.
M. Storto (2005)
10.2214/AJR.06.1104
How I do it: CT pulmonary angiography.
C. Wittram (2007)
10.1053/CRAD.2000.0573
Thoracic computed tomography in patients with suspected malignant pleural effusions.
Z. Traill (2001)
10.1148/RADIOLOGY.199.1.8633144
Effect of rate of contrast medium injection on hepatic enhancement at CT.
P. Garcia (1996)
10.2214/AJR.163.2.8037023
Understanding and optimizing use of contrast material for CT of the liver.
R. Baron (1994)
10.1016/j.crad.2007.02.024
Effect of duration of contrast material injection on peak enhancement times and values of the aorta, main portal vein, and liver at dynamic MDCT with the dose of contrast medium tailored to patient weight.
Sukru Mehmet Erturk (2008)
10.1378/CHEST.120.6.1798
Percutaneous image-guided cutting needle biopsy of the pleura in the diagnosis of malignant mesothelioma.
R. F. Adams (2001)
10.2214/AJR.169.3.9275877
Localized benign fibrous tumors of the pleura.
G. Ferretti (1997)
10.1016/J.CRAD.2005.05.015
Use of imaging in the management of malignant pleural mesothelioma.
R. Benamore (2005)
10.1148/RADIOLOGY.219.2.R01MA07510
Percutaneous image-guided cutting-needle biopsy of the pleura in the presence of a suspected malignant effusion.
R. Adams (2001)
10.1148/RADIOLOGY.175.1.2315473
Parietal pleural changes in empyema: appearances at CT.
R. J. Waite (1990)
10.1148/RADIOLOGY.192.3.8058951
Pleural exudates and transudates: diagnosis with contrast-enhanced CT.
S. Aquino (1994)
Percutaneous image - guided cutting needle biopsy of the pleura in the presence of a suspected malignant pleural effusion
RF Adams (2001)
10.2214/AJR.07.2067
Prevalence and significance of asymptomatic venous thromboembolic disease found on oncologic staging CT.
C. Cronin (2007)
10.1148/RADIOGRAPHICS.17.1.9017800
Complex disease of the pleural space: radiographic and CT evaluation.
J. Kuhlman (1997)
10.1148/RADIOLOGY.193.2.7972771
Hepatic CT enhancement. Part II. Alterations in contrast material volume and rate of injection within the same patients.
T. Chambers (1994)
10.1148/RG.233025165
From the archives of the AFIP: Localized fibrous tumor of the pleura.
M. Rosado-de-Christenson (2003)



This paper is referenced by
10.7861/clinmedicine.13-5-452
Developing a 'pleural team' to run a reactive pleural service.
R. Bhatnagar (2013)
10.1016/J.EJCDT.2014.09.001
The use of multi-detector computed tomography and ultrasonography for evaluation of pleural lesions
Adel Salah Bediwy (2015)
10.1186/s41747-020-00184-z
Impact of iodine concentration and scan parameters on image quality, contrast enhancement and radiation dose in thoracic CT
Marian S. Solbak (2020)
10.1016/j.lungcan.2018.01.014
Early Contrast Enhancement: A novel magnetic resonance imaging biomarker of pleural malignancy
S. Tsim (2018)
10.1055/s-0039-1698285
Management of Malignant Pleural Effusions-What Is New.
Rajesh Thomas (2019)
10.1016/j.ctrv.2012.11.004
Second Italian consensus conference on malignant pleural mesothelioma: state of the art and recommendations.
C. Pinto (2013)
10.1097/CPM.0b013e3182a4a165
Imaging of Pleural Disease
Vineeta Sethi (2013)
Multidetector CT Scan of the Chest Versus Transthoracic Ultrasound in Diagnosis of Pleural
Diseases Yamamah (2016)
10.1183/20734735.0365-2018
An uncommon cause of pleural effusion
Amit Panjwani (2019)
10.1016/j.rmed.2017.02.013
State-of-the-art: Radiological investigation of pleural disease.
R. Hallifax (2017)
10.1183/2312508x.10032419
Radiology in pleural disease: what is the role of chest radiographs, CT and PET in modern management?
Laura Duerden (2020)
10.23750/abm.v88i2.5558
Diagnostic imaging and workup of malignant pleural mesothelioma
Luciano Cardinale (2017)
10.1007/s13665-014-0076-2
Imaging of pleural effusions: a pictorial review
J. M. Porcel (2014)
10.1007/978-3-319-30355-0_24
MDCT of the Chest Wall
Beth Ripley (2016)
10.1259/bjr.20180254
Early and delayed phases of contrast-enhanced CT for evaluating patients with malignant pleural effusion. Results of pairwise comparison by multiple observers.
J. Arenas-Jiménez (2018)
The Egyptian Society of Chest Diseases and Tuberculosis Egyptian Journal of Chest Diseases and Tuberculosis
Ashraf Abd El Halim (2013)
10.5935/2238-3182.20160055
Approach of parapneumonic pleural effusion in children in the form of a concept map
Lenisse Estelle Abrantes Gonçalves Amorim (2016)
10.1016/j.lungcan.2016.11.010
The diagnostic performance of routinely acquired and reported computed tomography imaging in patients presenting with suspected pleural malignancy
S. Tsim (2017)
10.1007/978-3-319-46904-1_15
The Pleurae, Thoracic Wall, and Diaphragm
Giovanna Bertolini (2017)
10.12968/HMED.2012.73.11.626
Imaging the pleura.
C. Mortensen (2012)
10.1159/000347003
The Role of CT Pulmonary Angiography in the Investigation of Unilateral Pleural Effusions
C. Hooper (2013)
10.31983/jimed.v6i1.5562
ANALISIS INFORMASI CITRA ANATOMI MSCT THORAX DENGAN KASUS EFUSI PLEURA KANKER PARU PADA WINDOW MEDIASTINUM POST KONTRAS MENGGUNAKAN VARIASI NILAI WINDOW WIDTH
Tri Puji Hastuti (2020)
10.1097/RTI.0000000000000476
Performance of Computed Tomographic Pulmonary Angiography Compared With Standard Chest Computed Tomography for Identification of Solid Organ, Serosal, and Nodal Findings
J. Anderson (2020)
10.1007/s13665-012-0011-3
Diagnosis of pleural infection: state-of-the-art
Claire L. Tobin (2012)
10.1007/978-3-319-46904-1
Body MDCT in Small Animals
G. Bertolini (2017)
10.1111/vru.12706
Nodules and masses are associated with malignant pleural effusion in dogs and cats but many other intrathoracic CT features are poor predictors of the effusion type.
Jennifer A Reetz (2019)
10.21037/shc.2018.07.01
Advances in mesothelioma imaging and implications for surgical management
K. Blyth (2018)
10.4103/ijri.IJRI_34_19
Imaging protocols for CT chest: A recommendation
A. Bhalla (2019)
10.3978/j.issn.2072-1439.2012.01.12
Pleural infection-current diagnosis and management.
A. Rosenstengel (2012)
10.1016/j.critrevonc.2016.05.004
The Third Italian Consensus Conference for Malignant Pleural Mesothelioma: State of the art and recommendations.
S. Novello (2016)
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