Assessment of the Use of a Saline Chaser to Reduce the Volume of Contrast Medium in Abdominal CT

Orlandini, F.; Boini, Stéphanie; Iochum-Duchamps, Sandrine; Batch, T.; Zhu, Xavier; Blum, Alain

doi:10.2214/ajr.04.0942

Cited by 19 publications

(15 citation statements)

References 16 publications

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“…Since the late 1990s various clinical reports have been published on saline-chaser technique for computed tomography (CT) angiography of the head and neck, thorax, and abdomen [1][2][3][4][5][6][7]. The saline-chaser technique results in greater efficiency of the administered contrast medium dose by avoiding accumulation of the contrast medium in the injection tubing and in the venous system between the injection site and the atrium of the right heart [4,7].…”

Section: Introductionmentioning

confidence: 99%

“…The saline-chaser technique results in greater efficiency of the administered contrast medium dose by avoiding accumulation of the contrast medium in the injection tubing and in the venous system between the injection site and the atrium of the right heart [4,7]. The increased contrast medium efficiency can be used either to obtain enhancement or to reduce contrast medium volume.…”

Section: Introductionmentioning

confidence: 99%

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Effect of varying injection rates of a saline chaser on aortic enhancement in CT angiography: phantom study

et al. 2008

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The effect of varying injection rates of a saline chaser on aortic enhancement in computed tomography (CT) angiography was determined. Single-level, dynamic CT images of a physiological flow phantom were acquired between 0 and 50 s after initiation of contrast medium injection. Four injection protocols were applied with identical contrast medium administration (150 ml injected at 5 ml/s). For baseline protocol A, no saline chaser was applied. For protocols B, C, and D, 50 ml of saline was injected at 2.5 ml/s, 5 ml/s, and 10 ml/s, respectively. Injecting the saline chaser at twice the rate as the contrast medium yielded significantly higher peak aortic enhancement values than injecting the saline at half or at the same rate as the contrast medium (P < 0.05). Average peak aortic enhancement (HU) measured 214, 214, 218, and 226 for protocols A, B, C, and D, respectively. The slower the saline-chaser injection rate, the longer the duration of 90% peak enhancement: 13.6, 12.2, and 11.7 s for protocols B, C, and D, respectively (P > 0.05). In CT angiography, saline chaser injected at twice the rate as the contrast medium leads to increased peak aortic enhancement and saline chaser injected at half the rate tends towards prolonging peak aortic enhancement plateau.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effect of varying injection rates of a saline chaser on aortic enhancement in CT angiography: phantom study

et al. 2008

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“…Saline flush has been used to reduce the contrast medium dose while maintaining the enhancement of the aorta [12][13][14] and iliac arteries [15]. Saline flush is also used in coronary CT angiography to increase the coronary enhancement [3].…”

Section: Discussionmentioning

confidence: 99%

Spiral Flow Fube for Contrast Medium Reduction in Coronary CT Angiography

Tomizawa¹,

Hayakawa²,

Inoh³

et al. 2017

ICFJ

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ObjectivesTo assess the diagnostic performance and enhancement of coronary CT with reduced contrast medium using the spiral flow tube compared with the T-shaped tube.MethodsWe retrospectively included 444 patients who underwent catheter examination within 2 months after coronary CT. The first 222 patients received 21.0 mgI/kg/s of contrast medium using the T-shaped tube and the injected contrast medium was reduced by 6% (19.8 mgI/kg/s) in the last 222 patients using the spiral flow tube. We compared the per vessel diagnostic performance for detecting obstructive stenosis (≥50%) by catheter examination and the enhancement of proximal coronary arteries.ResultsThe sensitivity, specificity, positive predictive value, negative predictive value and accuracy was 96%, 84%, 72%, 98% and 87% using the spiral flow tube and 93%, 83%, 68%, 97% and 86% using the T-shaped tube, respectively, without significance. The enhancement of left main (spiral flow vs T-shape, 407 ± 53 vs 407 ± 62 HU, p = 0.95) and right coronary (419 ± 58 vs 415 ± 61 HU, p = 0.49) arteries did not show significant difference.ConclusionsThe spiral flow tube would maintain the diagnostic performance and coronary enhancement with reduced contrast medium compared with the T-shaped tube.

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“…Saline flush is also used in imaging the aorta [10][11][12] and carotid arteries [13] . A previous study showed that approximately 10 to 20 mL of contrast medium remained in the brachial vein or the superior vena cava without saline flush [14] .…”

Section: Discussionmentioning

confidence: 99%

“…A previous study showed that approximately 10 to 20 mL of contrast medium remained in the brachial vein or the superior vena cava without saline flush [14] . By pushing this residual contrast medium into the central venous system, a saline flush could achieve a reduction of 12 mL [15] or 10% dose of contrast medium [3,11] with maintained arterial enhancement in the arterial phase. Other studies showed that saline flush increased the enhancement of coronary arteries [3] and aorta [10] by 10%.…”

Section: Discussionmentioning

confidence: 99%

Spiral Flow Tube for Saline Flush in Coronary CT Angiography: Initial Experience

Tomizawa

Hayakawa

Inoh

et al. 2016

International Journal of Radiology

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AIM:To compare the enhancement and visibility of coronary arteries using the spiral flow tube with that of the T-tube during coronary CT angiography. MATERIALS AND METHODS:This retrospective study consisted of 110 patients. The first 55 patients underwent coronary CT angiography with the conventional T-tube, while the last 55 patients used the novel spiral flow tube. Coronary attenuation of proximal and distal segments were measured and the signal-to-noise ratio (SNR) were calculated. To assess the visibility of distal segments, the number of coronary branches of 1 mm at their origin was counted. RESULTS: The spiral flow tube significantly increased the average attenuation of proximal (413 ± 40 vs 438 ± 45 HU, p <0.005) and distal segments (403 ± 46 vs 441 ± 46 HU, p<0.0001). The SNR in the spiral tube group tended to be higher than the T-tube group and the difference was significant in distal segments (14.0 ± 2.9 vs 15.4 ± 4.1, p = 0.04). The depiction of coronary branches improved with the spiral flow tube (16.0 ± 4.8 vs 17.8 ± 4.4, p = 0.04). CONCLUSION: The spiral flow tube increased the enhancement of coronary arteries and improved the visibility of distal segments in coronary CT angiography.

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Assessment of the Use of a Saline Chaser to Reduce the Volume of Contrast Medium in Abdominal CT

Cited by 19 publications

References 16 publications

Effect of varying injection rates of a saline chaser on aortic enhancement in CT angiography: phantom study

Effect of varying injection rates of a saline chaser on aortic enhancement in CT angiography: phantom study

Spiral Flow Fube for Contrast Medium Reduction in Coronary CT Angiography

Spiral Flow Tube for Saline Flush in Coronary CT Angiography: Initial Experience

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