{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T19:51:27Z","timestamp":1779133887081,"version":"3.51.4"},"reference-count":33,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2021,10,21]],"date-time":"2021-10-21T00:00:00Z","timestamp":1634774400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: Computed tomography angiography (CTA) in infants is considered one of the most challenging radiological examinations due to difficulties in balancing start delay, contrast agent (CA) volume and flow in order to achieve optimal opacification of the large vessels. This study aimed to compare the contrast enhancement achieved by four CAs when taking into consideration CA injection parameters and patient characteristics. Methods: We performed a retrospective assessment of forty-eight consecutive cardiothoracic CTAs performed for aortic arch evaluation on children aged 0\u20131 year. All examinations were performed using the same 64-slice scanner and power injector using the bolus tracking technique. Axial 0.6 mm slices were used to measure large vessel enhancement using regions of interest at the level of the main pulmonary artery, ascending and descending aorta. The recorded variables included anthropometric measurements, CA type, flow rate, volume, and the average Hounsfield unit (HU) values of the blood pool. Descriptive statistics are presented as averages and standard deviations (SD) for normal distributed data or otherwise as medians and interquartile ranges (IQRs). Results: We found no statistically significant differences between age and anthropometric parameters when looking at different CAs. The median CA volume was 7 (IQR, 7\u20139) mL with the average flow rate of 0.94 (SD, 0.23) mL\/s. Ascending aorta average HU values were 605.9 (SD, 177.23) for Iomeprol 350, 626 (SD, 183.83) for Ioversol 350, 530.83 (SD, 175.56) for Iopromide 370 and 354.91 (SD, 115.81) for Iodixanol 320. The difference in HU value for Iodixanol 320 compared to the other CAs was statistically significant. Similar differences were found for the other vascular structures. Conclusion: In CTA of infants suspected of aortic arch hypoplasia\/coarctation, Iodixanol 320 provided up to 40% less enhancement of the great vessels when compared to Iomeprol 350, Ioversol 350 and Iopromide 370.<\/jats:p>","DOI":"10.3390\/children8110949","type":"journal-article","created":{"date-parts":[[2021,10,21]],"date-time":"2021-10-21T14:37:48Z","timestamp":1634827068000},"page":"949","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Cardiothoracic CTA in Infants Referred for Aortic Arch Evaluation\u2014Retrospective Comparison of Iomeprol 350, Ioversol 350, Iopromide 370 and Iodixanol 320"],"prefix":"10.3390","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5324-9780","authenticated-orcid":false,"given":"Marian","family":"Pop","sequence":"first","affiliation":[{"name":"ME1 Department, \u201cGeorge Emil Palade\u201d University of Medicine Pharmacy Sciences and Technology of Tirgu Mures, 540142 Tirgu Mures, Romania"},{"name":"Radiology and Medical Imaging Department, Tirgu Mures Emergency Institute for Cardiovascular Diseases and Heart Transplant, 540136 Tirgu Mures, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,10,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1890","DOI":"10.1016\/S0735-1097(02)01886-7","article-title":"The incidence of congenital heart disease","volume":"39","author":"Hoffman","year":"2002","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1007\/s00330-010-2036-8","article-title":"Paediatric cardiac computed tomography: A review of imaging techniques and radiation dose consideration","volume":"21","author":"Young","year":"2010","journal-title":"Eur. Radiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41598-019-54498-z","article-title":"Chest CTA in children younger than two years\u2014A retrospective comparison of three contrast injection protocols","volume":"9","author":"Nagy","year":"2019","journal-title":"Sci. Rep."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1016\/j.jcct.2015.07.004","article-title":"Computed Tomography Imaging in Patients with Congenital Heart Disease Part I: Rationale and Utility. An Expert Consensus Document of the Society of Cardiovascular Computed Tomography (SCCT): Endorsed by the Society of Pediatric Radiology (SPR) and the North American Society of Cardiac Imaging (NASCI)","volume":"9","author":"Han","year":"2015","journal-title":"J. Cardiovasc. Comput. Tomogr."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1016\/j.jcct.2015.07.007","article-title":"Computed Tomography Imaging in Patients with Congenital Heart Disease, Part 2: Technical Recommendations. An Expert Consensus Document of the Society of Cardiovascular Computed Tomography (SCCT): Endorsed by the Society of Pediatric Radiology (SPR) and the North American Society of Cardiac Imaging (NASCI)","volume":"9","author":"Han","year":"2015","journal-title":"J. Cardiovasc. Comput. Tomogr."},{"key":"ref_6","first-page":"104","article-title":"Critical Neonatal Congenital Heart Disease\u2014A Rare Complication after Successful Surgical Correction","volume":"6","author":"Muntean","year":"2021","journal-title":"J. Cardiovasc. Emergencies"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"17","DOI":"10.2478\/jce-2021-0002","article-title":"A Particular Infantile Scimitar Syndrome Variant with Anomalous Systemic Arterial Supply-Inferior Vena Cava Fistula","volume":"7","author":"Blesneac","year":"2021","journal-title":"J. Cardiovasc. Emergencies"},{"key":"ref_8","first-page":"106","article-title":"In Search for Optimal Image Quality in Pediatric Cardiac CT Angiogram","volume":"116","author":"Faria","year":"2021","journal-title":"Arq. Bras. Cardiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1464","DOI":"10.2214\/AJR.19.22745","article-title":"Pediatric Cardiac CT and MRI: Considerations for the General Radiologist","volume":"215","author":"DiGeorge","year":"2020","journal-title":"Am. J. Roentgenol."},{"key":"ref_10","unstructured":"(2021, August 20). ACR Manual On Contrast Media 2020 ACR Committee on Drugs and Contrast Media. Available online: https:\/\/www.acr.org\/-\/media\/ACR\/Files\/Clinical-Resources\/Contrast_Media.pdf."},{"key":"ref_11","first-page":"220","article-title":"ECR 2019 Book of abstracts. Comparison of Iodixanol 320, Iomeprol 350 and Iopromide 370 effectiveness in CT cardiothoracic angiography in infants","volume":"Volume 10","author":"Pop","year":"2019","journal-title":"Proceedings of the Insights into Imaging"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1016\/j.mayocp.2012.01.012","article-title":"Clinical Pharmacology, Uses, and Adverse Reactions of Iodinated Contrast Agents: A Primer for the Non-radiologist","volume":"87","author":"Pasternak","year":"2012","journal-title":"Mayo Clin. Proc."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Thomsen, H.S., and Webb, J.A.W. (2014). Contrast Media. Safety Issues and ESUR Guidelines, Springer. Medical Radiology.","DOI":"10.1007\/978-3-642-36724-3"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"W47","DOI":"10.2214\/AJR.07.2541","article-title":"Contrast Enhancement in Cardiac MDCT: Comparison of Iodixanol 320 Versus Iohexol 350","volume":"190","author":"Tsai","year":"2008","journal-title":"Am. J. Roentgenol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1097\/MCA.0b013e328338cd0b","article-title":"Comparison of a low-osmolar contrast medium, iopamidol, and an iso-osmolar contrast medium, iodixanol, in MDCT coronary angiography","volume":"21","author":"Ozbulbul","year":"2010","journal-title":"Coron. Artery Dis."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"722","DOI":"10.3109\/02841851.2010.488249","article-title":"Heart rate variability and heat sensation during CT coronary angiography: Low-osmolar versus iso-osmolar contrast media","volume":"51","author":"Svensson","year":"2010","journal-title":"Acta Radiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/j.ijcard.2012.04.038","article-title":"Comparison of iodixanol 320 and iohexol 350 in image quality during 64-slice multidetector computed tomography: Prospective randomized study","volume":"158","author":"Choi","year":"2012","journal-title":"Int. J. Cardiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1016\/j.acra.2016.02.005","article-title":"Diagnostic Accuracy, Image Quality, and Patient Comfort for Coronary CT Angiography Performed Using Iso-Osmolar versus Low-Osmolar Iodinated Contrast: A Prospective International Multicenter Randomized Controlled Trial","volume":"23","author":"Nakazato","year":"2016","journal-title":"Acad. Radiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1148\/radiol.2017162779","article-title":"Iodixanol versus Iopromide at Coronary CT Angiography: Lumen Opacification and Effect on Heart Rhythm\u2014The Randomized IsoCOR","volume":"286","author":"Lubbers","year":"2017","journal-title":"Radiology"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1007\/s11547-020-01253-4","article-title":"Impact of various iodine concentrations of iohexol and iodixanol contrast media on image reconstruction techniques in a vascular-specific contrast media phantom: Quantitative and qualitative image quality assessment","volume":"126","author":"Saade","year":"2021","journal-title":"Radiol. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1016\/j.ijcard.2015.03.240","article-title":"Comparison of contrast enhancement, image quality and tolerability in Coronary CT angiography using 4 contrast agents: A prospective randomized trial","volume":"186","author":"Honoris","year":"2015","journal-title":"Int. J. Cardiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1148\/radiol.2333030668","article-title":"Intravenous contrast material administration at 16-detector row helical CT coronary angiography: Test bolus versus bolus-tracking technique","volume":"233","author":"Cademartiri","year":"2004","journal-title":"Radiology"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"20190868","DOI":"10.1259\/bjr.20190868","article-title":"Impact of CT Injector Technology and Contrast Media Viscosity on Vascular Enhancement: Evaluation in a Circulation Phantom","volume":"93","author":"Mcdermott","year":"2020","journal-title":"Br. J. Radiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1097\/RLI.0b013e31821c7ff4","article-title":"Multicenter comparison of high concentration contrast agent iomeprol-400 with iso-osmolar iodixanol-320: Contrast enhancement and heart rate variation in coronary dual-source computed tomographic angiography","volume":"46","author":"Becker","year":"2011","journal-title":"Investig. Radiol."},{"key":"ref_25","unstructured":"(2021, August 20). IBM Corp IBM SPSS Statistics for Windows 2017. Available online: https:\/\/www.ibm.com\/products\/spss-statistics."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1007\/s00247-017-3795-z","article-title":"Subjective and objective image differences in pediatric computed tomography cardiac angiography using lower iodine concentration","volume":"47","author":"Hwang","year":"2017","journal-title":"Pediatr. Radiol."},{"key":"ref_27","first-page":"309","article-title":"Development of synthetic growth charts for Romanian population","volume":"12","author":"Pascanu","year":"2016","journal-title":"Acta Endocrinol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"307","DOI":"10.24846\/v22i3y201307","article-title":"A web-based nutritional assessment tool","volume":"22","author":"Pop","year":"2013","journal-title":"Stud. Inform. Control"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1148\/radiol.10090908","article-title":"Intravenous contrast medium administration and scan timing at CT: Considerations and approaches","volume":"256","author":"Bae","year":"2010","journal-title":"Radiology"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1148\/radiol.2413040128","article-title":"CT Angiography of Pulmonary Arteries to Detect Pulmonary Embolism: Improvement of Vascular Enhancement with Low Kilovoltage Settings1","volume":"241","author":"Weber","year":"2006","journal-title":"Radiology"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1220","DOI":"10.2214\/AJR.11.8122","article-title":"80-kV Pulmonary CT Angiography With 40 mL of Iodinated Contrast Material in Lean Patients: Comparison of Vascular Enhancement With Iodixanol (320 mg I\/mL)and Iomeprol (400 mg I\/mL)","volume":"199","author":"Faggioni","year":"2012","journal-title":"Am. J. Roentgenol."},{"key":"ref_32","unstructured":"(2021, August 23). Visipaque FDA NDA 20-351\/S-013 Volume 1, Available online: https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2003\/20351slr013_visipaque_lbl.pdf."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1177\/028418519203300622","article-title":"Smedby Viscosity of some contemporary contrast media before and after mixing with whole blood","volume":"33","author":"Smedby","year":"1992","journal-title":"Acta Radiol."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/8\/11\/949\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:20:24Z","timestamp":1760167224000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/8\/11\/949"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,21]]},"references-count":33,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2021,11]]}},"alternative-id":["children8110949"],"URL":"https:\/\/doi.org\/10.3390\/children8110949","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,21]]}}}