title: Dual bolus intravenous contrast injection technique for multiregion paediatric body CT.
abstract: OBJECTIVE
  Optimal vascular and parenchymal enhancement for multi-region paediatric body computed tomography (CT) has many challenges. A variety of approaches are currently employed, associated with varying image quality and radiation dose implications. We present a dual bolus intravenous (DBI) contrast technique for single-acquisition imaging of the chest, abdomen and pelvis, with evaluation of multi-compartmental vascular enhancement.
  
  
  METHODS
  A DBI regime was designed for use with a programmable dual head pump injector. A larger initial bolus (two-thirds volume) is followed by a smaller bolus (one-third volume) before imaging the chest, abdomen and pelvis in a single acquisition, 45-65 seconds from the start of initial injection. Flow rates and second bolus timing were tailored to patient weight and contrast volume, using five weight categories. Multi-compartmental vascular opacification was graded and image quality was assessed in a cohort of 130 patients.
  
  
  RESULTS
  The DBI technique resulted in concordant multi-compartmental (thoracic aortic, pulmonary arterial, abdominal aortic and portal venous) vascular enhancement. Early splenic parenchymal enhancement artefacts and alterations to renal enhancement were observed.
  
  
  CONCLUSIONS
  We present a weight-stratified dual bolus intravenous contrast technique to improve image quality in paediatric multi-region body CT.
  
  
  CONCLUSIONS
  • In children, optimal vascular and parenchymal enhancement in multi-region CT is challenging. • A dual bolus contrast technique offers concordant arterial and portal venous opacification. • Adaptation to patient size is achieved by stratification into five weight categories. • Dose penalties of 'overlap' and 'dual phase' imaging techniques can be avoided.
authors.affiliation: Department of Diagnostic Imaging, The Hospital for Sick Children, 555 University Avenue, Toronto, M5G 1X8, Canada, karen.thomas@sickkids.ca.
authors.forename: Karen E
authors.initials: KE
authors.lastname: Thomas
authors.forename: E H
authors.initials: EH
authors.lastname: Mann
authors.forename: N
authors.initials: N
authors.lastname: Padfield
authors.forename: L
authors.initials: L
authors.lastname: Greco
authors.forename: G
authors.initials: G
authors.lastname: BenDavid
authors.forename: A
authors.initials: A
authors.lastname: Alzahrani
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003287:Contrast Media / Q000008:administration & dosage*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007275:Injections, Intravenous / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods*; D051598:Whole Body Imaging / Q000379:methods*
chemical_list: D003287:Contrast Media