64-section multidetector CT of the upper abdomen: optimization of a saline chaser injection protocol for improved vascular and parenchymal contrast enhancement

Eur Radiol. 2011 Sep;21(9):1938-47. doi: 10.1007/s00330-011-2139-x. Epub 2011 May 11.

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.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Abdominal Cavity / diagnostic imaging*
  • Adult
  • Aged
  • Aged, 80 and over
  • Aorta, Abdominal / diagnostic imaging
  • Chi-Square Distribution
  • Contrast Media*
  • Female
  • Humans
  • Injections, Intravenous
  • Linear Models
  • Liver / diagnostic imaging
  • Male
  • Middle Aged
  • Pancreas / diagnostic imaging
  • Prospective Studies
  • Radiographic Image Enhancement / methods*
  • Reference Values
  • Sensitivity and Specificity
  • Sodium Chloride / pharmacology*
  • Tomography, Spiral Computed / methods*
  • Young Adult

Substances

  • Contrast Media
  • Sodium Chloride