Intravenous Contrast Material Administration at 16–Detector Row Helical CT Coronary Angiography: Test Bolus versus Bolus-tracking Technique

PURPOSE: To compare test bolus and bolus-tracking techniques for intravenous contrast material administration at 16–detector row computed tomographic (CT) coronary angiography.

MATERIALS AND METHODS: This study had institutional review board approval, and patients gave informed consent. Thirty-eight patients (mean age, 60 years; three women) were randomized into two groups according to bolus timing technique: group 1 (20-mL test bolus with 100-mL main bolus) and group 2 (bolus tracking with 100-mL main bolus). All patients underwent electrocardiography-gated 16–detector row CT coronary angiography with 12 detectors (collimation, 0.75 mm; rotation time, 420 msec). In group 1, test bolus peak attenuation was used as a delay, while in group 2, a +100-HU threshold in ascending aorta triggered angiographic acquisition, with an additional 4-second delay for patient instruction. Attenuation was measured in the longitudinal direction throughout the examination in three main vessels: ascending aorta (region of interest [ROI] 1), descending aorta (ROI 2), and main pulmonary artery (ROI 3). Mean attenuation and slope of bolus geometry curve were calculated in each patient and ROI. Attenuation at origin of coronary arteries was measured. Student t test was used to compare results.

RESULTS: Mean scan delay was 6 seconds longer in group 2 (P < .05). Average attenuation values were 306.6 HU ± 44.0 (standard deviation) and 328.2 HU ± 58.6 (P > .05) in ROI 1, 291.6 HU ± 45.1 and 326.4 HU ± 62.6 (P > .05) in ROI 2, and 354.7 HU ± 78.0 and 305.3 HU ± 71.4 (P < .05) in ROI 3 for groups 1 and 2, respectively. Average slope values were 5.8 and −0.8 (P < .05) in ROI 1, 7.7 and 0.7 (P < .05) in ROI 2, and −1.0 and −13.3 (P < .05) in ROI 3 for groups 1 and 2, respectively. Average attenuation values in left main, left anterior descending, and left circumflex arteries were higher in group 2 (P < .05); there were no differences (P > .05) between groups in right coronary artery.

CONCLUSION: Bolus-tracking yields more homogeneous enhancement than does the test bolus technique.

© RSNA, 2004


  • 1 Achenbach S, Ulzheimer S, Baum U, et al. Noninvasive coronary angiography by retrospectively ECG-gated multislice spiral CT. Circulation 2000; 102:2823-2828. Crossref, MedlineGoogle Scholar
  • 2 Nieman K, Oudkerk M, Rensig BJ, et al. Coronary angiography with multislice computed tomography. Lancet 2001; 357:599-603. Crossref, MedlineGoogle Scholar
  • 3 Knez A, Becker CR, Leber A, et al. Usefulness of multislice spiral computed tomography angiography for determination of coronary artery stenoses. Am J Cardiol 2001; 88:1191-1194. Crossref, MedlineGoogle Scholar
  • 4 Flohr T, Stierstorfer K, Bruder H, Simon J, Schaller S. New technical developments in multislice CT. I. Approaching isotropic resolution with sub-millimeter 16-slice scanning. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 2002; 174:839- 845. CrossrefGoogle Scholar
  • 5 Flohr T, Bruder H, Stierstorfer K, Simon J, Schaller S, Ohnesorge B. New technical developments in multislice CT. II. Sub-millimeter 16-slice scanning and increased gantry rotation speed for cardiac imaging. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 2002; 174:1022-1027. CrossrefGoogle Scholar
  • 6 Heuschmid M, Kuttner A, Flohr T, et al. Visualization of coronary arteries in CT as assessed by a new 16 slice technology and reduced gantry rotation time: first experiences. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 2002; 174:721-724. [German]. CrossrefGoogle Scholar
  • 7 Nieman K, Cademartiri F, Lemos PA, Raaijmakers R, Pattynama PM, de Feyter PJ. Reliable noninvasive coronary angiography with fast submillimeter multislice spiral computed tomography. Circulation 2002; 106:2051-2054. Crossref, MedlineGoogle Scholar
  • 8 Ropers D, Baum U, Pohle K, et al. Detection of coronary artery stenoses with thin-slice multi-detector row spiral computed tomography and multiplanar reconstruction. Circulation 2003; 107:664-666. Crossref, MedlineGoogle Scholar
  • 9 Cademartiri F, van der Lugt A, Luccichenti G, Pavone P, Krestin GP. Parameters affecting bolus geometry in CTA: a review. J Comput Assist Tomogr 2002; 26:598-607. Crossref, MedlineGoogle Scholar
  • 10 Bae KT, Heiken JP, Brink JA. Aortic and hepatic peak enhancement at CT: effect of contrast medium injection rate—pharmacokinetic analysis and experimental porcine model. Radiology 1998; 206:455-464. LinkGoogle Scholar
  • 11 Fleischmann D, Rubin GD, Bankier AA, Hittmair K. Improved uniformity of aortic enhancement with customized contrast medium injection protocols at CT angiography. Radiology 2000; 214:363-371. LinkGoogle Scholar
  • 12 Kopka L, Rodenwaldt J, Fischer U, Mueller DW, Oestmann JW, Grabbe E. Dual-phase helical CT of the liver: effects of bolus tracking and different volumes of contrast material. Radiology 1996; 201:321-326. LinkGoogle Scholar
  • 13 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; 55:368-373. Crossref, MedlineGoogle Scholar
  • 14 Mehnert F, Pereira PL, Trubenbach J, Kopp AF, Claussen CD. Automatic bolus tracking in monophasic spiral CT of the liver: liver-to-lesion conspicuity. Eur Radiol 2001; 11:580-584. Crossref, MedlineGoogle Scholar
  • 15 Mehnert F, Pereira PL, Trubenbach J, Kopp AF, Claussen CD. Biphasic spiral CT of the liver: automatic bolus tracking or time delay? Eur Radiol 2001; 11:427-431. Crossref, MedlineGoogle Scholar
  • 16 Sandstede JJ, Tschammler A, Beer M, Vogelsang C, Wittenberg G, Hahn D. Optimization of automatic bolus tracking for timing of the arterial phase of helical liver CT. Eur Radiol 2001; 11:1396-1400. Crossref, MedlineGoogle Scholar
  • 17 Macari M, Israel GM, Berman P, et al. Infrarenal abdominal aortic aneurysms at multi-detector row CT angiography: intravascular enhancement without a timing acquisition. Radiology 2001; 220:519-523. LinkGoogle Scholar
  • 18 Nieman K, Rensing BJ, van Geuns RJ, et al. Usefulness of multislice computed tomography for detecting obstructive coronary artery disease. Am J Cardiol 2002; 89:913-918. Crossref, MedlineGoogle Scholar
  • 19 Vogl TJ, Abolmaali ND, Diebold T, et al. Techniques for the detection of coronary atherosclerosis: multi-detector row CT coronary angiography. Radiology 2002; 223:212-220. LinkGoogle Scholar
  • 20 Achenbach S, Giesler T, Ropers D, et al. Detection of coronary artery stenoses by contrast-enhanced, retrospectively electrocardiographically-gated, multislice spiral computed tomography. Circulation 2001; 103:2535-2538. Crossref, MedlineGoogle Scholar
  • 21 Prokop M. Multislice CT angiography. Eur J Radiol 2000; 36:86-96. Crossref, MedlineGoogle Scholar

Article History

Published in print: Dec 2004