valuation of Intravenous Contrast Agents Timing and Enhancement in Non-Traumatic Abdomen and Pelvis CT Exams

Mo’ath Hussein Ismail Almakhamreh
معاذ حسين مخامرة
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Al-Quds University
Background: Among the advances that ensured better diagnosis in CT imaging is the use of contrast medium (CM). CM increase image quality by providing higher signal to noise ratio, contrast to noise ratio, and enhancing contrast between internal organs resulting in significant improvement in image quality and hence better diagnosis. Being advantageous means substantial use of the radiologic CM, nevertheless these chemical substances must be administered carefully in terms of timing, and other interrelated factors to improve image quality and to prevent or minimize any adverse effects. The CM used in CT exams is iodine-based that can be ingested or injected intravenously (IV). Awareness of iodinated CM regarding its effects is crucial since its effects can vary from low to life threatening. Even life threatening reactions are rare but they can happen and should be treated promptly. Methods: A cross sectional prospective study was conducted from January 2020 to April 2020. 80 patients from different medical institutions underwent Abdomen, and Pelvis CT scans with IV CM were included; the process of CM timing and other CM related factors including volume, injection rate, injection duration, and concentration were evaluated by comparing the HUs that were a result of using different parameters to the recommended standards. The attenuation values in the Hounsfield Unit (HU) for liver and aorta were measured. The average HU was compared between the 4 groups of institutions. Results: Variation was observed in CT contrast policies and procedures. Widely varying aortic and hepatic enhancement resulted from random use and wide range of timing and other CM factors. Aortic enhancement ranged from 98-361HU, and hepatic enhancement ranged from 13-76 HU, respectively. Mean± SD of maximal aortic enhancement was 264.25±60.23, 213.45±50.83, 200.85±39.2, and 164.2±48.27 .Mean ± SD of maximal enhancement of the liver was 53.4±10.3, 44.9±12, 45.8±10, 34.6±10.1 in institutions A, B, C and D, respectively. Conclusion: Random use of CM timing and protocols will result in less patient safety and widely varying range of enhancement and peak parenchymal enhancement with less homogeneous enhancement.