Download PDF
CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2014; 24(02): 125-128
DOI: 10.4103/0971-3026.134387
Vascular and Interventional Radiology

Automatic scan triggering software "confused": Computed tomography angiography in foot arteriovenous malformation!

Pankaj Gupta
Department of Radio diagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh, India
,
Anindita Sinha
Department of Radio diagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh, India
,
Niranjan Khandelwal
Department of Radio diagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh, India
› Author Affiliations
› Further Information
Also available at
  PDF Download Permissions and Reprints

Abstract

Multidetector computed tomography angiography (MDCTA) has become a well-established modality for limb angiography for a variety of indications. The technique of MDCTA depends on the scanner features including the number of detector rows, rotation speeds and single or dual source energy. Integral to a diagnostic quality CTA is the acquisition timing. Various techniques are available for determining the appropriate timing of scan acquisition which includes fixed delay, test bolus and the bolus tracking technique. The transit times of contrast from the aorta to the peripheral arteries shows a wide variability and is dependent upon the inter individual hemodynamic states. The bolus tracking technique is the most preferred one which allows reliable scan timing with acceptable contrast volume and radiation dose. Pitfalls with all these techniques are well described and we report one such technical pitfall in a case of left foot arteriovenous malformation (AVM) where the bolus tracking technique employed for scan triggering failed to initiate acquisition.

Keywords

Arterio‑venous malformation - bolus tracking - computed tomography angiography - contrast injection


Publication History

Article published online:
02 August 2021

© 2014. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 

  • References

  • 1 Rubin GD, Schmidt AJ, Logan LJ, Sofilos MC. Multi-detector row CT angiography of lower extremity arterial inflow and runoff: Initial experience. Radiology 2001;221:146-58.
  • 2 Keeling AN, Farrelly C, Carr JC, Yaghmai V. Technical considerations for lower limb multidetector computed tomographic angiography. Vasc Med 2011;16:131.
  • 3 Walls MC, Thavendiranathan P, Rajagopalan S. Advances in CT Angiography for peripheral arterial disease. Cardiol Clin 2011;29:331-40.
  • 4 Kock MC, Dijkshoorn ML, Pattynama PM, Myriam Hunink MG. Multi-detector row computed tomographyangiography of peripheral arterial disease. Eur Radiol 2007;17:3208-22.
  • 5 Martin ML, Tay KH, Flak B, Fry PD, Doyle DL, Taylor DC, et al. Multidetector CT angiography of the aortoiliac system and lower extremities: A prospective comparison with digital subtraction angiography. AJR Am J Roentgenol 2003;180:1085-91.
  • 6 Cademartiri F, Nieman K, van der Lugt A, Raaijmakers RH, Mollet N, Pattynama PM, et al. Intravenous contrast material administration at 16-detector row helical CT coronary angiography: Test bolus versus bolus-tracking technique. Radiology 2004;233:817-23.
  • 7 Bae KT. Test bolus versus bolus tracking technique for CT angiographic timing. Radiology 2005;236:369-70.
  • 8 Willmann JK, Mayer D, Banyai M, Desbiolles LM, Verdun FR, Seifert B, et al. Evaluation of peripheral arterial bypass grafts with multi-detector row CT angiography: Comparison with duplex US and digital subtraction angiography. Radiology 2003;229:465-74.
  • 9 Keeling AN, Farelly C, Carr JC, Yaghmai V. Technical considerations for lower limb multidetector computed tomographic angiography. Vasc Med 2010;16:131-43.
  • 10 Bae KT. Technical aspects of contrast delivery in advanced CT. Appl Radiol 2003;32:12-9.
  • 11 Hsu RM. Computed tomographic angiography: Conceptual review of injection and acquisition parameters with a brief overview of rendering techniques. Appl Radio 2002;31:33-9.
  • 12 Boulpaep EL. Arteries and Veins. In: Boron WF, Boulpaep EL, editors. Medical Physiology 2 nd ed. New York: Elsevier; 2011. p. 467-81.
  • 13 Kitai T, Haraguchi T. Optimal scan timing in 64-row MDCT angiography of the lower extremities: 2-point ROI detection bolus-tracking method. Nihon Hoshasen Gijutsu Gakkai Zasshi 2011;67:51-6.
  • 14 Bae KT, Tran HQ, Heiken JP. Uniform vascular contrast enhancement and reduced contrast volume achieved by exponential-decay contrast injection method. Radiology 2004;231:732-6.
  • 15 Eisa F, Brauweiler R, Peetz A, Hupfer M, Nowak T, Kalender WA. Optical tracking of contrast medium bolus to optimize bolus shape and timing in dynamic computed tomography. Phys Med Biol 2012;57:N173-82.
  • 16 Cademartiri F, Mollet N, van der Lugt A, Nieman K, Pattynama PM, de Feyter PJ, et al. Non-invasive 16-row multislice CT coronary angiography: Usefulness of saline chaser. Eur Radiol 2004;14:178-83.
  • 17 Haage P, Schmitz-Rode T, Hubner D, Piroth W, Gunther RW. Reduction of contrast material dose and artifacts by a saline flush using a double power injector in helical CT of the thorax. AJR Am J Roentgenol 2000;174:1049-53.
  • 18 de Monyé C, Cademartiri F, de Weert TT, Siepman DA, Dippel DW, van Der Lugt A. Sixteen-detector row CT angiography of carotid arteries: Comparison of different volumes of contrast material with and without a bolus chaser. Radiology 2005;237:555-62.
  • 19 Bae KT. Peak contrast enhancement in CTA and MRA: When does it occur and why? Radiology 2003;227:809-16.