title: Carotid CT angiography: comparison of image quality for left versus right arm injections.
abstract: OBJECTIVE
  To evaluate the differences in image quality of carotid computed tomographic angiography (CTA) of patients injected with contrast material in their right arms versus patients injected with contrast material in their left arms.
  
  
  METHODS
  Patients who had cerebrovascular accidents and subsequently underwent CTA were included in the study. Contrast material was injected into the right arms of 44 patients and into the left arms of 46 patients. Source images of a total of 90 CTAs were retrospectively evaluated for perivenous streak artifacts and contrast material reflux into the veins of the neck and upper thorax. After adjusting for differences in gender, the relationship between the injection site and the intensity of perivenous streak artifacts and venous reflux was determined.
  
  
  RESULTS
  Perivenous streak artifacts and venous reflux were demonstrated in patients who underwent either right or left arm injections. However, the intensity of perivenous streak artifacts was stronger in patients who were injected with contrast material in the left arm. Venous reflux into the neck and upper thorax veins was also more severe and more frequent with left arm injections. A decreased retrosternal distance facilitated reversed flow into the veins when the left arm injection was used.
  
  
  CONCLUSIONS
  Perivenous beam hardening streak artifacts and venous reflux could not be prevented with right or left arm injections. However, patients who were injected with contrast material in their right arms showed fewer artifacts, thus allowing for better quality images on CTA.
authors.affiliation: Department of Radiology, Balıkesir University School of Medicine, Balıkesir, Turkey. gulendemirpolat@hotmail.com
authors.forename: Gülen
authors.initials: G
authors.lastname: Demirpolat
authors.forename: Mürvet
authors.initials: M
authors.lastname: Yüksel
authors.forename: Gülgün
authors.initials: G
authors.lastname: Kavukçu
authors.forename: Deniz
authors.initials: D
authors.lastname: Tuncel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001132:Arm / Q000098:blood supply*; D016477:Artifacts; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D002533:Cerebral Angiography / Q000379:methods*; D015331:Cohort Studies; D003287:Contrast Media; D005260:Female; D007839:Functional Laterality; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D011786:Quality Control; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D020521:Stroke / Q000175:diagnosis / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D003287:Contrast Media