valuation of Intravenous Contrast Agents Timing and Enhancement in Non-Traumatic Abdomen and Pelvis CT Exams
Date
2022-08-16
Authors
Mo’ath Hussein Ismail Almakhamreh
معاذ حسين مخامرة
Journal Title
Journal ISSN
Volume Title
Publisher
Al-Quds University
Abstract
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.