CTPA in Patients with Pulmonary Embolism: Compare Test Bolus and Bolus Tracking Methods

ORIGINAL ARTICLE
Hanan Elnour, Faisal Alzaidy, Mohamed Alotaibi, Malek Alsulymani, Muath Alosaimi, Hamid Osman, Mona Elhaj, Raga Ahmed Abouraida, Awadia Gareeballah, Rufida E. Eisa Ahmed, Ali Abdelrazig

 
For citation: Elnour H, Alzaidy F, Alotaibi M, Alsulymani M, Alosaimi M, Osman H, Elhaj M, Abouraida RA, Gareeballah A, Ahmed REE, Abdelrazig A. CTPA in Patients with Pulmonary Embolism: Compare Test Bolus and Bolus Tracking Methods. International Journal of Biomedicine. 2024;14(3):464-468. doi:10.21103/Article14(3)_OA12
 
Originally published September 6, 2024

Abstract: 

Background: Computed tomography pulmonary angiography (CTPA) is a non-invasive imaging method that can quickly diagnose pulmonary embolism. This study aimed to compare test bolus and bolus track contrast enhancement protocols to determine the optimal technique for CTPA in the diagnosis of pulmonary embolism.
Methods and Results: This retrospective study was conducted at the King Abdul-Aziz Specialist Hospital (KASH) in Taif city from September 2022 to March 2023. Ninety-eight patients with suspected PE were included in the study: underwent CTPA using the test bolus (TB) approach, and 49 patients underwent CTPA using the bolus tracking (BT) approach. The examination was performed using a 128-slice CT scanner. Densities of pulmonary arteries were measured based on the Hounsfield unit (HU) and compared between two groups (TB and BT) based on gender and age. The mean HU of the pulmonary arteries was significantly higher in the TB group than that of the BT group (392.06±110.77 HU and 298.9±93.098 HU, respectively, P=0.001). There was no statistically significant difference in the mean HU between females of the two groups [P=0.062]. In contrast, men in the TB group had a substantially greater density (384.7±116 HU) than men in the BT group (273.0±88.0 HU) [P=0.001]. There were no statistically significant differences between the two groups based on age except for the age subgroup 46-55 years; the TB group exhibited considerably higher density (421.54±138.148 HU) than the BT group (255.2±82.155 HU) [P=0.003]. The ANOVA test showed no statistically significant correlation between the effects of tracking systems, gender, and age on tracking intensity [P=0.640].
Conclusion: Both TB and BT procedures are accurate for diagnosing pulmonary embolism. A TB protocol results in significantly better opacification of the pulmonary arteries in men aged 46 to 55 than the BT protocol.

Keywords: 
pulmonary embolism • computed tomography pulmonary angiography • test bolus • bolus tracking
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Received May 4, 2024.
Accepted August 8, 2024.
©2024 International Medical Research and Development Corporation.