title: Contrast material administration protocols for 64-MDCT angiography: altering volume and rate and use of a saline chaser to better match the imaging window--physiologic phantom study.
abstract: OBJECTIVE
  The purpose of our study was to evaluate the effect of varying volumes and rates of contrast material, use of a saline chaser, and cardiac output on aortic enhancement characteristics in MDCT angiography (MDCTA) using a physiologic phantom.
  
  
  METHODS
  Volumes of 75, 100, and 125 mL of iopamidol, 370 mg I/mL, were administered at rates of 4, 6, and 8 mL/s. The effect of a saline chaser (50 mL of normal saline, 8 mL/s) was evaluated for each volume and rate combination. Normal, reduced (33% and 50%), and increased (25%) cardiac outputs were simulated. Peak aortic enhancement and duration of peak aortic enhancement were recorded. Analysis of variance models were run with these effects, and the estimated mean levels for the sets of factor combinations were determined.
  
  
  RESULTS
  Lowering the volume of contrast material resulted in reduced peak enhancement (example, -56.2 HU [p < 0.0001] with 75 vs 125 mL) and reduced duration of 75% peak enhancement (example, -9.0 seconds [p < 0.0001] with 75 vs 125 mL). Increasing the rate resulted in increased peak enhancement (example, 104.5 HU [p < 0.0001] with a rate of 8 vs 4 mL/s) and decreased duration of 75% peak enhancement (example, -13.0 seconds [p < 0.001]). Use of a saline chaser resulted in increased peak enhancement, and this increase was inversely proportional to contrast material volume. Peak enhancement increased when reduced cardiac output was simulated. Peak enhancement decreased when increased cardiac output was simulated.
  
  
  CONCLUSIONS
  Reducing contrast material volume from 125 to 75 mL, increasing the rate to 6 or 8 mL/s, and use of a saline chaser result in an aortic enhancement profile that better matches the approximately 5-second imaging window possible with 64-MDCTA of the abdomen and pelvis. Even smaller volumes of contrast material may be adequate in patients with reduced cardiac output.
authors.affiliation: Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA.
authors.forename: Courtney A
authors.initials: CA
authors.lastname: Coursey
authors.forename: Rendon C
authors.initials: RC
authors.lastname: Nelson
authors.forename: Paul W
authors.initials: PW
authors.lastname: Weber
authors.forename: Laurens E
authors.initials: LE
authors.lastname: Howle
authors.forename: Eli B
authors.initials: EB
authors.lastname: Nichols
authors.forename: Daniele
authors.initials: D
authors.lastname: Marin
authors.forename: David
authors.initials: D
authors.lastname: DeLong
mesh_terms: D000704:Analysis of Variance; D001783:Blood Flow Velocity; D003287:Contrast Media / Q000008:administration & dosage*; D017023:Coronary Angiography / Q000379:methods*; D004867:Equipment Design; D006801:Humans; D007479:Iopamidol / Q000008:administration & dosage*; D019047:Phantoms, Imaging; D011857:Radiographic Image Interpretation, Computer-Assisted; D012965:Sodium Chloride / Q000008:administration & dosage*; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media; D012965:Sodium Chloride; D007479:Iopamidol