title: Effect of Right-Sided Versus Left-Sided Contrast Injection on Intra-arterial Opacification Characteristics of Head and Neck Computed Tomography Angiograms and Interactions With Patient Sex, Weight, and Cardiac Output.
abstract: OBJECTIVE
  The aims of this study were to support the standard clinical assumption that preferential right-sided injection (RSI) over left-sided injection (LSI) results in improved head and neck computed tomography angiograms and to determine which patients most benefit from RSIs.
  
  
  METHODS
  Head and neck computed tomography angiograms of 453 RSIs and 419 LSIs were included. Interactions between injection side, age, weight, body mass index, and left ventricular ejection fraction with mean vessel Hounsfield units (HU) were compared. Statistical analysis was performed using 2-tailed Student t tests, Mann-Whitney U tests, and simple linear (SL) and multiple linear regressions.
  
  
  RESULTS
  Right-sided injection yielded higher HU for patients older than 40 years (eg, RSI of the right common carotid artery [RCCA] vs LSI of the RCCA; P < 0.01). Body mass index (eg, RCCA; r = -0.31, P < 0.01 [SL]) and weight (eg, RCCA; r = -0.39, P < 0.01 [SL]) were negatively correlated with HU. Female had higher HU (mean ± SE, +39.7 ± 7.6 HU; P < 0.01 [multiple linear]). Left ventricular ejection fraction had no interactions with injection side or HU.
  
  
  CONCLUSIONS
  The findings support preferential RSI in patients older than 40 years with higher body mass index and weight, particularly male.
authors: From the *Department of Radiology, Boston Medical Center, School of Medicine, †School of Medicine; ‡Department of Health Policy and Management, School of Public Health, Departments of §Otolaryngology, Head and Neck Surgery, and ∥Radiation Oncology, Boston Medical Center, School of Medicine, Boston University, Boston, MA.
authors: Yu-Ming
authors: YM
authors: Chang
authors: Amy C
authors: AC
authors: Tsai
authors: Alexander
authors: A
authors: Gutierrez
authors: Marta
authors: M
authors: Flory
authors: Rutuparna
authors: R
authors: Sarangi
authors: Akifumi
authors: A
authors: Fujita
authors: Thomas
authors: T
authors: Brahler
authors: Cindy L
authors: CL
authors: Christiansen
authors: Osamu
authors: O
authors: Sakai
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000379:methods; D015992:Body Mass Index; D001835:Body Weight; D002302:Cardiac Output; D002339:Carotid Arteries / Q000000981:diagnostic imaging*; D002536:Cerebral Arteries / Q000000981:diagnostic imaging*; D002648:Child; D003287:Contrast Media / Q000008:administration & dosage*; D005260:Female; D006257:Head / Q000098:blood supply / Q000000981:diagnostic imaging; D006801:Humans; D007601:Jugular Veins / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000098:blood supply / Q000000981:diagnostic imaging; D011856:Radiographic Image Enhancement; D012737:Sex Factors; D014057:Tomography, X-Ray Computed; D055815:Young Adult
chemical_list: D003287:Contrast Media