title: Reduction of contrast medium volume in abdominal aorta CTA: multiphasic injection technique versus a test bolus volume.
abstract: OBJECTIVE
  The purpose of this study is to reduce the administered contrast medium volume in abdominal CTA by using a test bolus injection, with the preservation of adequate quantitative and qualitative vessel enhancement.
  
  
  METHODS
  For this technical efficacy study 30 patients, who were referred for a CTA examination of the abdominal aorta, were included. Randomly 15 patients were assigned to undergo a multiphasic injection protocol and received 89 mL of contrast medium (Optiray 350) (protocol I). Fifteen patients were assigned to the test bolus injection protocol (protocol II), which implies injection of a 10 mL test bolus of Optiray 350 prior to performing CTA with a 40 mL of contrast medium. Quantitative assessment of vascular enhancement was performed by measuring the amount of Hounsfield Units in the aorta at 30 positions from the celiac trunk to the iliac arteries in both groups. Qualitative assessment was performed by three radiologists who scored the images at a 5-point scale.
  
  
  RESULTS
  Quantitative assessment showed that there was no significant difference in vascular enhancement for patients between the two protocols, with mean attenuation values of 280.9 ± 50.84 HU and 258.60 ± 39.28 HU, respectively. The image quality of protocol I was rated 4.31 (range: 3.67/5.00) and of protocol II 4.11 (range: 2.67/5.00). These differences were not statistically significant.
  
  
  CONCLUSIONS
  This study showed that by using a test bolus injection and the administration of 50 mL of contrast medium overall, CTA of the abdominal aorta can reliably be performed, with regard to quantitative and qualitative adequate vessel enhancement.
authors.affiliation: University of Twente, MIRA-Institute for Biomedical Technology and Technical Medicine, P.O. Box 21, 7500 AE Enschede, The Netherlands. w.h.nijhof@student.utwente.nl
authors.forename: Wouter H
authors.initials: WH
authors.lastname: Nijhof
authors.forename: Charlotte S
authors.initials: CS
authors.lastname: van der Vos
authors.forename: Bauke
authors.initials: B
authors.lastname: Anninga
authors.forename: Gerrit J
authors.initials: GJ
authors.lastname: Jager
authors.forename: Matthieu J C M
authors.initials: MJ
authors.lastname: Rutten
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging*; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging*; D001027:Aortography; D003287:Contrast Media / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014283:Triiodobenzoic Acids / Q000008:administration & dosage*
chemical_list: D003287:Contrast Media; D014283:Triiodobenzoic Acids; C054871:ioversol
keywords: Abdominal aorta; CT angiography; Image quality; Iodinated contrast medium; Test bolus injection