Contrast Enhancement of the Right Ventricle during Coronary CT Angiography – Is It Necessary?

About the Authors:

Madeleine Kok

* E-mail: [email protected]

Affiliations Department of Radiology, Maastricht University Medical Center, Maastricht, The Netherlands, CARIM Cardio Vascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands

Bas L. J. H. Kietselaer

Affiliations Department of Radiology, Maastricht University Medical Center, Maastricht, The Netherlands, CARIM Cardio Vascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands, Department of Cardiology, Maastricht University Medical Center, Maastricht, the Netherlands

Casper Mihl

Affiliations Department of Radiology, Maastricht University Medical Center, Maastricht, The Netherlands, CARIM Cardio Vascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands

Sibel Altintas

Affiliations CARIM Cardio Vascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands, Department of Cardiology, Maastricht University Medical Center, Maastricht, the Netherlands

Estelle C. Nijssen

Affiliation: Department of Radiology, Maastricht University Medical Center, Maastricht, The Netherlands

Joachim E. Wildberger

Affiliations Department of Radiology, Maastricht University Medical Center, Maastricht, The Netherlands, CARIM Cardio Vascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands

Marco Das

Affiliations Department of Radiology, Maastricht University Medical Center, Maastricht, The Netherlands, CARIM Cardio Vascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands

Introduction

Previous studies have shown that multidetector-row computed tomography (MDCT) produces very high diagnostic image quality for a wide range of heart rates [1, 2]. Due to its high temporal resolution, not only evaluation of the coronary arteries, but also functional evaluation of the heart has become possible [1]. Takx et al. [3] reported that right ventricle (RV) morphology and function can be assessed during contrast enhanced CT of the heart. Quiroz et al. [4] found that RV enlargement deduced from CT images correlates with RV dysfunction seen on echocardiography.

Studies on RV function have been overshadowed by studies on left ventricular (LV) function [5], since the RV is generally considered to be affected by pathological processes affecting the cardiovascular system, and not a causal factor [6]. However, the RV is affected by, and contributes to, a number of disease processes, including not only acute pulmonary embolism (PE) and pulmonary artery hypertension (PAH), but also cardiomyopathy (CMP), RV ischemia or infarction, and tumour formation [6, 7].

Although RV assessment was shown to be feasible during CT angiography (CTA) of the heart, contrast timing has not...