Many investigators have described comparisons of contrast media with different iodine concentrations in the enhancement of multiple organs and vessels on CT scans. Contrary to other solid organs, the kidney excretes waste products, including contrast media, via the cortex, medulla, and pelvicalyceal system. For the kidney, there are characteristic enhancing techniques such as the use of the arterial phase for cortex and venous phase for medullary during contrast CT imaging. In our study, we compared the degree of renal parenchymal enhancement in the Hounsfield Unit (HU) by the use of 350 and 370 mg I/ml in contrast enhanced computed tomography (CECT) abdomen at the origin of renal artery of right and left Kidney in the arterial phase for both groups. The comparison of renal parenchymal enhancement between the A group and B group showed that the renal parenchymal enhancement is higher in B group. This was a prospective randomized study in which 116 participants were allocated in two groups using the random convenience sampling method. The subjects were divided into two groups; Group A (350 mgI/ml and Group B (370 mgI/ml). All data were analyzed by an independent t-test to obtain the mean difference between all the variables using 350 mgI/ml and 370mgI/ml. Quantitative data like age, height, weight, Body Mass Index(BMI), pulse rate, creatinine, flow rate, contrast volume, and ejection fraction were presented as mean and standard deviation using an independent t-test. Qualitative data like gender was presented as a percentage. P-value was calculated using an independent t-test. P-value <0.05 was considered to be statistically significant. Data were analyzed by statistical Package for Social Science version 20.0 (IBM corporation, New York, 2014). Analyzing the data using the independent-test revealed that differences between the two groups were found to be statistically significant (P=0.029). The comparison of renal parenchymal enhancement between the A group and B group showed that the renal parenchymal enhancement is higher in the B group with a t = -2.213 and is statistically significant (P = 0.029). Non-ionic contrast medium of concentration 370 mg I/ml showed higher mean renal parenchyma peak enhancement as compared to 350 mg I/ml. Further, our study showed that the renal parenchymal enhancement pattern between A group and B group was affected by weight, BMI, and pulse rate and contrast volume.
Keywords: Renal Parenchyma, Iodinated Contrast Medium, Multidetector CT, Hounsfield Unit
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REFERENCES
Setty BN, Sahani DV, Ouellette-Piazzo K, Hahn PF, Shepard JA. Comparison of enhancement, Image quality, Cost, and adverse reactions using 2 different contrast medium concentrations for routine chest CT on 16-slice MDCT. J Comput Assist Tomogr. 2006 Sep–Oct;30(5):818-22. doi: 10.1097/01.rct.0000229999.30897.3b, PMID 16954936.
Tozaki M, Naruo K, Fukuda K. Dynamic contrast-enhanced MDCT of the liver: analysis of the effect of different iodine concentrations with the same total iodine dose in the same chronic liver disease patients. Radiat Med. 2005 Dec;23(8):533-8. PMID 16555560.
Bae KT. Intravenous contrast medium administration and scan timing at CT: considerations and approaches. Radiology. 2010 Jul;256(1):32-61. doi: 10.1148/radiol.10090908, PMID 20574084
Heiken JP, Brink JA, McClennan BL, Sagel SS, Crowe TM, Gaines MV. Dynamic incremental ct: effect of volume and concentration of contrast material and patient weight on hepatic enhancement. Radiology. 1995 May;195(2):353-7. doi: 10.1148/radiology.195.2.7724752, PMID 7724752
Puskás Z, Schuierer G. Determination of blood circulation time for optimizing contrast medium administration in CT angiography. Radiologe. 1996 Sep;36(9):750-7. doi: 10.1007/s001170050138, PMID 8999453.
Kirchner J, Kickuth R, Laufer U, Noack M, Liermann D. Optimized enhancement in helical CT: experiences with a real-time bolus tracking system in 628 patients. Clin Radiol. 2000 May;55(5):368-73. doi: 10.1053/crad.2000.0376, PMID 10816403.
Bae KT, Heiken JP, Brink JA. Aortic and hepatic contrast medium enhancement at CT. part II. Effect of reduced cardiac output in a porcine model. Radiology. 1998 Jun;207(3):657-62. doi: 10.1148/radiology.207.3.9609887, PMID 9609887.
Chu LL, Joe BN, Westphalen ACA, Webb EM, Coakley FV, Yeh BM. Patient-specific time to peak abdominal organ enhancement varies with time to peak aortic enhancement at MR imaging. Radiology. 2007 Dec;245(3):779-87. doi: 10.1148/radiol.2451061585, PMID 17911535.
Suzuki H, Oshima H, Shiraki N, Ikeya C, Shibamoto Y. Comparison of two contrast materials with different iodine concentrations in enhancing the density of the aorta, portal vein and liver at multi-detector row CT: A randomized study. Eur Radiol. 2004 Nov;14(11):2099-104. doi: 10.1007/s00330-004-2439-5, PMID 15309493
Itoh S, Ikeda M, Satake H, Ota T, Ishigaki T. The effect of patient age on contrast enhancement during CT of the pancreatobiliary region. AJR. 2006 Aug;187(2):505-10.
Cademartiri F, Mollet NR, van der Lugt A, McFadden EP, Stijnen T, de Feyter PJ, Krestin GP. Intravenous contrast material administration at helical 16-detector row CT coronary angiography: effect of iodine concentration on vascular attenuation. Radiology. 2005 Aug;236(2):661-5. doi: 10.1148/radiol.2362040468, PMID 16040923.
Bae KT. Comparison of moderate versus high concentration of contrast media injected at the same total iodine dose and fixed injection duration. Radiology. 2005 Aug;236(2):740-1; author reply 741. doi: 10.1148/radiol.2362050096, PMID 16040930.
Ho LM, Nelson RC, Delong DM. Determining contrast medium dose and rate on basis of lean body weight: does this strategy improve patient-to-patient uniformity of hepatic enhancement during multi-detector row CT? Radiology. 2007 May;243(2):431-7. doi: 10.1148/radiol.2432060390, PMID 17456869.
Platt JF, Reige KA, Ellis JH. Aortic enhancement during abdominal CT angiography: correlation with test injections, flow rates, and patient demographics. AJR Am J Roentgenol. 1999 Jan;172(1):53-6. doi: 10.2214/ajr.172.1.9888738, PMID 9888738.
Yamaguchi I, Hayashi H, Suzuki M, Ichikawa K, Kidoya E, Kimura H. Operation of bolus tracking system for prediction of aortic peak enhancement at multidetector row computed tomography: pharmacokinetic analysis and clinical study. Radiat Med. 2008 Jun;26(5):278-86. doi: 10.1007/s11604-008-0228-9, PMID 18661212.
Utsunomiya D, Awai K, Tamura Y, Nishiharu T, Urata J, Sakamoto T, Taniguchi A, Yamashita Y. 16-MDCT aortography with a low-dose contrast material protocol. AJR Am J Roentgenol. 2006 Feb;186(2):374-8. doi: 10.2214/AJR.04.1459, PMID 16423941.
Behrendt FF, Mahnken AH, Stanzel S, Seidensticker P, Jost E, Günther RW, Mühlenbruch G. Intraindividual comparison of contrast media concentrations for combined abdominal and thoracic mdct. AJR Am J Roentgenol. 2008 Jul;191(1):145-50. doi: 10.2214/AJR.07.3176, PMID 18562738.
Faggioni L, Gabelloni M. Iodine concentration and optimization in computed tomography angiography: Current Issues. Invest Radiol. 2016 Dec;51(12):816-22. doi: 10.1097/RLI.0000000000000283, PMID 27272541.
Awai K, Inoue M, Yagyu Y, Watanabe M, Sano T, Nin S, Koike R, Nishimura Y, Yamashita Y. Moderate versus high concentration of contrast material for aortic and hepatic enhancement and tumor-to-liver contrast at multi-detector row ct. Radiology. 2004 Dec;233(3):682-8. doi: 10.1148/radiol.2333031617, PMID 15486215.
Itoh S, Ikeda M, Achiwa M, Satake H, Ota T, Ishigaki T. Multiphase contrast-enhanced ct of the liver with a multislice ctmultislicect scanner: effects of iodine concentration and delivery rate. Radiat Med. 2005 Feb;23(1):61-9. PMID 15786754.
Rubin GD, Lane MJ, Bloch DA, Leung AN, Stark P. Optimization of thoracic spiral ct: effects of iodinated contrast medium concentration. Radiology. 1996 Dec;201(3):785-91. doi: 10.1148/radiology.201.3.8939232, PMID 8939232
