ArticlePloS one2019
Incidence of transient interruption of contrast (TIC) - A retrospective single-centre analysis in CT pulmonary angiography exams acquired during inspiratory breath-hold with the breathing command: "Please inspire gently!"
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 17 citations in OpenAlex.
- Reduced variability of pulmonary artery enhancement using a single-acquisition combined first-pass and inferior-vena-cava-derived second-pass contrast technique in CT pulmonary angiography.Emergency radiology · 2026Article
- Deep Learning-Based Iodine Contrast Augmentation for Suboptimally Enhanced CT Pulmonary Angiography: Implications for Pulmonary Embolism Diagnosis.Diagnostics (Basel, Switzerland) · 2025Article
- Transient interruption of contrast on CT pulmonary angiography: effect of mid-inspiratory vs. end-inspiratory respiration command.Emergency radiology · 2024Article
- Addressing intimate partner violence during the COVID-19 pandemic and beyond: how radiologists can make a difference.European radiology · 2021Article
- Acute pulmonary embolism in non-hospitalized COVID-19 patients referred to CTPA by emergency department.European radiology · 2020Article
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Authors and funding
9 authors at 5 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo assess the occurrence of transient interruption of contrast (TIC) phenomenon in pulmonary computed tomography angiography (CTPA) exams performed in inspiratory breath-hold after patients were told to inspire gently.
methodsIn this retrospective single-centre study, CTPA exams of 225 consecutive patients scanned on a 16-slice CT scanner system were analysed. A-priori to measurements, exams were screened for inadequate pulmonary artery contrast due to incorrect bolus tracking or failure of i.v. contrast administration. Those exams were excluded. Attenuation values in the thoracic aorta and in the pulmonary trunk were assessed in duplicate measurements (M1 and M2) and the aorto-pulmonary density ratio was calculated. An aorto-pulmonary ratio > 1 with still contrast inflow being visible within the superior vena cava was defined as TIC.
results3 patients were excluded due to incorrect bolus tracking. Final analysis was performed in 222 patients (mean age 65 ± 19 years, range 18 to 99 years). Mean density in the pulmonary trunk was 275±17 HU, in the aorta 208 ± 15 HU. Mean aorto-pulmonary ratio was 0.81± 0.29. 48 patients (21.6%) had an aorto-pulmonary ratio >1. Correlation of mean aorto-pulmonary ratio and age was: -0.213 (p = 0.001). Age was not significantly different for an aorto-pulmonary ratio >1 vs. ≤1 (p = 0.122). Both in M1 and M2, 33/222 patients presented with absolute HU values of < 200 HU within the pulmonary artery. In M1 measurements, 24 of these 33 patients (72%) fulfilled TIC criteria (M2: 25/33 patients (75%)).
conclusionsTIC is a common phenomenon in CTPA studies with inspiratory breath-hold commands after patients were told to inspire gently with an incidence of 22% in our retrospective cohort. Occurrence of TIC shows a significant negative correlation with increasing age and disproportionately often occurs in patients with lower absolute contrast density values within their pulmonary arteries.
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