Abdominal multidetector row computed tomography: reduction of cost and contrast material dose using saline flush.
OBJECTIVE
To evaluate the potential of a saline solution flush after the contrast material bolus in abdominal multidetector row CT (MDCT) in contrast material dose and cost reduction.


METHODS
Abdominal MDCT was performed in 78 patients who were assigned randomly to 2 groups receiving 120 mL nonionic contrast material (300 mgI/mL) alone or 100 mL of the same contrast material pushed with 40 mL of saline solution. Mean attenuation values for both groups were measured in the liver, the spleen, the pancreas, the portal vein, the inferior vena cava, and the abdominal aorta. Cost analyses were performed for both groups.


RESULTS
There was no significant difference in parenchymal and vascular enhancement between both groups. The difference of the enhancement was 2 HU for the liver (P = 0.11), 2 HU for the spleen (P = 0.44), 3 HU for the pancreas (P = 0.38), 9 HU for the portal vein (P = 0.11), 3 HU for the inferior vena cava (P = 0.55), and 10 HU for the aorta (P = 0.06). Taking the costs of contrast material, saline solution, and disposal material into account, 7.30 dollars was saved by the patient using a saline solution flush.


CONCLUSIONS
Using a saline flush after the contrast material bolus in abdominal MDCT allows an iodine dose reduction of approximately 6 g, or 17%, without impairing mean parenchymal and vascular enhancement and a cost reduction of 7.30 dollars per patient.
Department of Radiology, University Hospital, Graz, Austria. helmut.schoellnast@uni-graz.at
Helmut
H
Schoellnast
Manfred
M
Tillich
Hannes A
HA
Deutschmann
Michael J
MJ
Deutschmann
Gerald A
GA
Fritz
Uwe
U
Stessel
Gottfried J
GJ
Schaffler
Martin M
MM
Uggowitzer
D000368:Aged; D003287:Contrast Media / Q000008:administration & dosage*; D003363:Cost Control; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011860:Radiography, Abdominal / Q000191:economics* / Q000379:methods*; D012965:Sodium Chloride / Q000008:administration & dosage; D014057:Tomography, X-Ray Computed / Q000191:economics* / Q000379:methods*
D003287:Contrast Media; D012965:Sodium Chloride