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[Artefact reducing in diagnosis of lung embolism using spiral CT with saline bolus].

PURPOSE
To improve the diagnostic efficacy of bolus-enhanced spiral CT (SCT) in the detection of pulmonary embolism using a saline push immediately after bolus injection of the contrast medium.


PATIENTS AND METHODS
The study included 90 patients with suspected acute or chronic pulmonary embolism. The CT scan was performed in a caudocephaled direction. In Group I (n = 60) we applied a bolus contrast injection (120 ml, 3 ml/s, 300 mg J/ml), after a median delay of 25 s. Group II (n = 30) had the same contrast injection which was immediately followed by an additional saline push (60 ml, 2 ml/s). Streak artifacts originating from high contrast concentrations in the superior vena cava were rated on a 4-point scale for different locations: right pulmonary artery, pars basalis, truncus anterior, and the segmental upper lobe arteries.


RESULTS
The incidence of artifacts in group I was nearly twice as high as in group II. The difference was significant (p < 0.05) for the upper and anterior superior lobe artery, the right pulmonary artery and the pars basalis.


CONCLUSION
The presented protocol significantly reduces artifacts mainly by a washout of contrast medium in the superior vena cava.