64-section multidetector CT of the upper abdomen: optimization of a saline chaser injection protocol for improved vascular and parenchymal contrast enhancement
Daniele Marin, Rendon C Nelson, Antonino Guerrisi, Huiman Barnhart, Sebastian T Schindera, Roberto Passariello, Carlo Catalano, Daniele Marin, Rendon C Nelson, Antonino Guerrisi, Huiman Barnhart, Sebastian T Schindera, Roberto Passariello, Carlo Catalano
Abstract
Objectives: To prospectively investigate the effect of varying the injection flow rates of a saline chaser on vascular and parenchymal contrast enhancement during abdominal MDCT.
Methods: 100 consecutive patients were randomly assigned to four injection protocols. A fixed dose of contrast medium was administered followed by no saline (Protocol A) or 50 mL of saline at 2, 4, or 8 mL/s (Protocols B, C, and D). Peak, time-to-peak, and duration of 90% peak enhancement were determined for aorta, pancreas, and liver.
Results: Aortic peak enhancement was significantly higher for Protocol D (369.5 HU) compared with Protocols A and B (332.9 HU and 326.0 HU, respectively; P < 0.05). Pancreatic peak enhancement was significantly higher for Protocols C and D (110.6 HU and 110.9 HU, respectively) compared to Protocol A (92.5 HU; P < 0.05). Aortic and pancreatic time-to-peak enhancement occurred significantly later for Protocol D compared with Protocol A (42.8 s vs. 36.1 s [P < 0.001] and 49.7 s vs. 45.3 s [P = 0.003]).
Conclusions: Injecting a saline chaser at high flow rates yields significantly higher peak aortic and pancreatic enhancement, with a slight longer time-to-peak enhancement.
References
- Eur Radiol. 2004 Sep;14(9):1665-73
- Radiology. 2010 Jul;256(1):32-61
- Radiology. 2007 Dec;245(3):779-87
- AJR Am J Roentgenol. 2003 Apr;180(4):929-34
- Radiology. 1998 Nov;209(2):411-6
- J Comput Assist Tomogr. 2005 Mar-Apr;29(2):195-201
- Eur Radiol. 2005 Dec;15 Suppl 5:E35-45
- AJR Am J Roentgenol. 2006 Feb;186(2):374-8
- Radiology. 1998 Mar;206(3):637-40
- AJR Am J Roentgenol. 2007 Mar;188(3):751-6
- AJR Am J Roentgenol. 2000 Apr;174(4):1049-53
- AJR Am J Roentgenol. 2010 Oct;195(4):825-9
- J Comput Assist Tomogr. 2003 Nov-Dec;27(6):847-53
- Eur J Radiol. 2010 Mar;73(3):688-93
- Radiology. 2003 Jun;227(3):809-16
- Radiology. 1998 Feb;206(2):455-64
- Radiology. 1997 Oct;205(1):269-71
- Invest Radiol. 2007 Jul;42(7):486-90
- Support Care Cancer. 2009 Nov;17(11):1433-4
- Eur Radiol. 2001;11(8):1396-400
- Radiology. 2008 Jan;246(1):110-5
- Radiology. 1998 Dec;209(3):837-43
- Radiology. 2007 Apr;243(1):80-7
- J Comput Assist Tomogr. 2002 Mar-Apr;26(2):287-91
- Clin Imaging. 2009 Jul-Aug;33(4):261-6
- AJR Am J Roentgenol. 2009 Dec;193(6):1568-75
- Eur Radiol. 2008 Aug;18(8):1683-9
- Radiology. 2005 Nov;237(2):555-62
- AJR Am J Roentgenol. 2006 Aug;187(2):548-54
- Radiology. 2006 Oct;241(1):167-74
- Eur Radiol. 2004 Apr;14(4):659-64
Source: PubMed