Contrast Use in CTA Applications

CTA protocols
The following protocols from the forum participants
will provide a valuable reference for planning CTA.

Multidetector cardiac CT Protocol for coronary Protocol for coronary calcium

protocol for coronary CT angiography: scoring, 64-slice CT scanner:
calcium scoring*: Stephan Achenbach, MD, Jill E. Jacobs, MD, New York
J. Jeffrey Carr, MD, MSCE, University of Erlangen– University Medical Center,
Wake Forest University, Nürnberg, Erlangen, Germany New York, NY
Winston-Salem, NC Scan duration: ~10–14 seconds Range Tracheal bifurcation
Scan range: ~130 mm to the bottom of the
kV: 120 heart
kV 120
mAs: 850 kV 120
mAs 70–150
Detector collimation: 0.6 mm Effective mAs 310
Slice thickness 2.5–3 mm
Slice thickness: 0.6–0.75 mm Slice
Field of view 26–35 cm
Reconstruction interval: 0.3–0.5 mm collimation 1.2 mm
Scan mode Axial–cardiac
Table feed: 3.8 mm/rotation Slice width 3 mm
Reconstruction Partial scan,
Gantry rotation time: 330 msec Pitch 0.2
Kernel–vendor-
Contrast volume: 50–70 mL Kernel B30f
dependent
Contrast rate: 5 mL/sec
ECG gating Prospective @
75% or 50% of
R-R interval
*Scan parameters are vendor- and system-
specific. All scan parameters should be con- Protocol for coronary CT angiography, 64-slice CT scanner:
firmed with manufacturers prior to imple-
menting in a clinical situation. Jill E. Jacobs, MD, New York University Medical Center,
New York, NY
Range Tracheal bifurcation to the bottom of the heart
kV 120
Effective mAs 700–900
Detector collimation 0.6 mm
Slice thickness 0.75 mm
Pitch 0.2 mm (0.18 for heart rate <50 bpm)
Rotation time 0.33 sec (0.37 sec for heart rate <50 bpm)
Reconstruction interval 0.5 mm
Kernel B30f
NPO 3 hours prior (no caffeine)
Intravenous contrast 70 to 100 mL iodixanol 320 mg I/mL
Saline chaser 40 mL
Injection rate 4 to 5 mL/sec
Beta-blocker Oral metoprolol, 50 to 100 mg, 1 hr prior to study
5 mg intravenously, as needed (15 mg maximum)
Nitroglycerin 0.4 mg sublingually immediately prior to study

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 Contrast Use in CTA Applications

Cardiac CT scanning protocol: Michael Poon, MD, Protocol for CT evaluation

Cabrini Medical Center, New York, NY of congenital heart disease in
Scanning parameters adults: Marilyn J. Siegel, MD,
Scanner 64-slice Mallinckrodt Institute of
Detector collimation 0.6 mm Radiology, Washington
Reconstruction interval 0.6 mm University School of
Rotation time 0.33 sec Medicine, St. Louis, MO
kV 120
mAs Detector collimation
Test bolus 40 16-slice 0.75 mm
CTA 850 64-slice 0.6 mm
Pitch Slice thickness 1 mm
Test bolus 0 Pitch 1–1.5
CTA 0.2 mm Image order Craniocaudal or
Scan range Carina to base of the heart reverse
Scan time 12–15 sec Reconstruction 1 or 2 mm
Dose modulation For heart rate <70 bpm intervals (3D)
Retrospective ECG gating 60% of R-R interval Contrast medium Nonionic
Concentration 350 mgI/mL
Contrast administration Volume 75–100 mL
Contrast agent Low osmolar Flow rate 3 to 4 mL/sec
Concentration 320 mg I/mL Scan timing Bolus tracking,
Volume scan triggered at
Test bolus 10 mL 100–120 HU
CTA 80 mL kV 120
Injection rate 4–5 mL/sec Effective mAs 140
Saline chaser 50 mL at same flow rate Rotation speed 0.5 sec
Image acquisition timing:
• Peak aortic enhancement (entire coronary circulation, including bypass
grafts)
• Peak aortic enhancement plus 3–4 seconds (native coronary arteries only)

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