Optimization of Contrast Enhancement in Thoracic MDCT

Many clinical applications of thoracic computed tomography (CT) require contrast medium to enhance and delineate vascular, mediastinal, hilar, and cardiac structures, and differentiate normal and pathologic vascular or tumoral conditions. Multidetector row computed tomography (MDCT) is superior to single-detector row CT (SDCT) because MDCT permits more efficient and flexible use of intravenous contrast medium to achieve enhancement. However, to fully reap the benefits of MDCT contrast enhancement, the technical challenges associated with optimizing enhancement and scan timing in MDCT need to be solved. This article reviews the basic principles of CT contrast enhancement and discusses common clinical considerations and the protocol design modifications that are necessary to achieve optimal contrast enhancement in thoracic MDCT.