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Suction/Inspiration against resistance or standardized Mueller maneuver : a new breathing technique to improve contrast density within the pulmonary artery: a pilot CT study

Gutzeit, Andreas ; Froehlich, Johannes ; Wälti, Stephan ; Roos, Justus ; Meissnitzer, Matthias ; Hergan, Klaus ; von Weymarn, Constantin ; Czell, David ; Goyen, Matthias ; Reischauer, Carolin

In: European Radiology, 2015, vol. 25, no. 11, p. 3133-3142

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    Titre
    • Suction/Inspiration against resistance or standardized Mueller maneuver
      a new breathing technique to improve contrast density within the pulmonary artery: a pilot CT study
    Auteur
    • Gutzeit, Andreas. Department of Radiology, Paracelsus Medical University Salzburg, Salzburg, Austria
    • Froehlich, Johannes. Institute of Radiology and Nuclear Medicine, Clinical Research Unit, Hirslanden Hospital St. Anna, St. Anna Strasse 12, 6006, Lucerne, Switzerland
    • Wälti, Stephan. Department of Radiology and Nuclear Medicine, Cantonal Hospital St. Gallen, 9007, St. Gallen, Switzerland
    • Roos, Justus. Department of Radiology, Duke University Medical Center, Durham, NC, USA
    • Meissnitzer, Matthias. Department of Radiology, Paracelsus Medical University Salzburg, Salzburg, Austria
    • Hergan, Klaus. Department of Radiology, Paracelsus Medical University Salzburg, Salzburg, Austria
    • von Weymarn, Constantin. Institute of Radiology and Nuclear Medicine, Clinical Research Unit, Hirslanden Hospital St. Anna, St. Anna Strasse 12, 6006, Lucerne, Switzerland
    • Czell, David. Department of Neurology, Cantonal Hospital Winterthur, Brauerstrasse 15, 8401, Winterthur, Switzerland
    • Goyen, Matthias. Institute of Radiology and Nuclear Medicine, Clinical Research Unit, Hirslanden Hospital St. Anna, St. Anna Strasse 12, 6006, Lucerne, Switzerland
    • Reischauer, Carolin. Department of Radiology, Paracelsus Medical University Salzburg, Salzburg, Austria
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • European Radiology, 2015, vol. 25, no. 11, p. 3133-3142. Springer Berlin Heidelberg
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:332960
    Summary
    Objective: Our aim was to prospectively investigate whether the recently introduced suction/inspiration against resistance breathing method leads to higher computed tomography (CT) contrast density in the pulmonary artery compared to standard breathing. Material and methods: The present study was approved by the Medical Ethics committee and all subjects gave written informed consent. Fifteen patients, each without suspicious lung emboli, were randomly assigned to four different groups with different breathing maneuvers (suction against resistance, Valsalva, inspiration, expiration) during routine CT. Contrast enhancement in the central and peripheral sections of the pulmonary artery were measured and compared with one another. Results: Peripheral enhancement during suction yielded increased mean densities of 138.14 Hounsfield units (HU) (p = 0.001), compared to Valsalva and a mean density of 67.97 HU superior to inspiration (p = 0.075). Finally, suction in comparison to expiration resulted in a mean increase of 30.51 HU (p = 0.42). Central parts of pulmonary arteries presented significantly increased enhancement values (95.74 HU) for suction versus the Valsalva technique (p = 0.020), while all other mean densities were in favour of suction (versus inspiration: p = 0.201; versus expiration: p = 0.790) without reaching significance. Conclusion: Suction/Inspiration against resistance is a promising technique to improve contrast density within pulmonary vessels, especially in the peripheral parts, in comparison to other breathing maneuvers. Key Points : • Suction/Inspiration against resistance is promising to improve contrast density within the pulmonary artery. • Patients potentially suffering pulmonary embolism are able to follow suction/inspiration against resistance. • Contrast density after suction is superior in comparison to other breathing maneuvers.