Optimization of Contrast Agent Volume for Helical CT in the Diagnostic Assessment of Patients with Severe and Multiple Injuries

Abstract

We recommend administration of 150 ml of iohexol as the optimal amount of contrast material for single phase bolus administration in emergency helical CT examination of the chest and abdomen.

Whole-body computed tomography for multiple traumas using a triphasic injection protocol

“…Densities were measured in all patients and served as secondary end-points and were determined by measuring vessel attenuation (in Hounsfield units, HU) in regions of interest (ROIs) that were placed in the ascending, descending, and abdominal aorta and covered a maximum of the vessel lumen (<1 cm 2 ). Ten regions including both arteries and veins were measured in each patient, and in addition, standard deviation of background noise was assessed [6,7].…”

“…The densities of parenchymal organs were measured by placing ROIs in the right and left lobes of the liver, in the spleen, and in the kidneys covering the largest possible area within the parenchyma but without including vessels, artifacts, or lesions (in the slice measured and in both adjacent slices, <3 cm 2 ) [6]. Density was measured in the lesion of patients with liver and spleen lacerations (n=10) and compared to artifacts caused by the arms at the side of the body (n=25).…”

“…Anatomy appears less delineated show that injection protocols with more than just one injection phase are advantageous compared to protocols that use a single injection phase. Bolus tracking is recommended for the upper abdomen [15], but not in patients with multiple trauma because of the circulatory instability present in most cases [2,6]. Instead, a fixed time delay using an amount of 150 mL seems to be the method of choice [2,6].…”

“…Different lesions, usually evaluated in different phases of contrast distribution, have to be illustrated: e.g., hematoma and ongoing arterial hemorrhage have to be distinguished, and parenchymal contusion or laceration of organs have to be depicted. A high dose of contrast media is generally accepted for adult multiple-trauma patients [6]. However, the administration of contrast medium is difficult because bolus tracking is often inadequate following multiple trauma on account of the circulatory instability present in most cases [2,6].…”

“…A high dose of contrast media is generally accepted for adult multiple-trauma patients [6]. However, the administration of contrast medium is difficult because bolus tracking is often inadequate following multiple trauma on account of the circulatory instability present in most cases [2,6].…”