Power Injection of Contrast Media Using Central Venous Catheters

Herts, Brian R.; O’Malley, Charles M.; Wirth, S.; Lieber, Michael L.; Pohlman, Brad

doi:10.2214/ajr.176.2.1760447

Cited by 65 publications

(45 citation statements)

References 25 publications

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“…A number of studies have addressed the issue of what level of hepatic enhancement constitutes the minimum acceptable for liver imaging: 30 HU [70], 40 HU [71][72][73], or 50 HU [9,33,[74][75][76][77]. In a multi-center study Megibow et al [19] found that 30 HU was the lowest limit of acceptable hepatic enhancement and that no definite clinical gain was achieved with hepatic enhancement greater than 50 HU.…”

Section: Contrast Enhancement Magnitudementioning

confidence: 99%

Scan and contrast administration principles of MDCT

Bae

Heiken

2005

Eur Radiol Suppl

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Because of its fast scan speed, multi-detector row CT (MDCT) imposes a challenge to optimization of contrast enhancement and scan timing. However, when this challenge is overcome with the use of precisely designed protocols, MDCT provides us with an opportunity to use contrast medium more efficiently and flexibly than with single-detector row CT (SDCT). To fully achieve the benefits of MDCT, it is crucial for radiologists and technologists to 1) understand the factors that determine contrast enhancement and scan timing for MDCT, and 2) identify the required modifications in protocol design to optimize contrast enhancement for MDCT. Clinical considerations for CTA and hepatic imaging are described in this article.

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Section: Contrast Enhancement Magnitudementioning

confidence: 99%

Scan and contrast administration principles of MDCT

Bae

Heiken

2005

Eur Radiol Suppl

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mentioning

confidence: 99%

“…during contrast-enhanced CT (ceCT), or were limited regarding injection pressure and flow [6]. Power contrast injections via TIVAPs have been evaluated in vitro, but only a few data on in vivo use of power injections via TIVAPs exist [6][7][8]. Recently, devices approved for power contrast injections (totally implantable venous power ports, TIVPPs) have been developed, but until today literature regarding the safety and use of power injections via these devices is limited to only one study on chest ports [9].…”

mentioning

confidence: 99%

Totally implantable venous power ports of the forearm and the chest: initial clinical experience with port devices approved for high-pressure injections

Goltz¹,

Noack²,

Petritsch³

et al. 2012

The British Journal of Radiology

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Objectives: To evaluate the technical success, clinical outcome and safety of percutaneously placed totally implantable venous power ports (TIVPPs) approved for high-pressure injections, and to analyse their value for arterial phase CT scans. Methods: Retrospectively, we identified 204 patients who underwent TIVPP implantation in the forearm (n5152) or chest (n552) between November 2009 and May 2011. Implantation via an upper arm (forearm port, FP) or subclavian vein (chest port, CP) was performed under sonographic and fluoroscopic guidance. Complications were evaluated following the standards of the Society of Interventional Radiology. Power injections via TIVPPs were analysed, focusing on adequate functioning and catheter's tip location after injection. Feasibility of automatic bolus triggering, peak injection pressure and arterial phase aortic enhancement were evaluated and compared with 50 patients who had had power injections via classic peripheral cannulas. Results: Technical success was 100%. Procedure-related complications were not observed. Catheter-related thrombosis was diagnosed in 15 of 152 FPs (9.9%, 0.02/100 catheter days) and in 1 of 52 CPs (1.9%, 0.002/100 catheter days) (p,0.05). Infectious complications were diagnosed in 9 of 152 FPs (5.9%, 0.014/100 catheter days) and in 2 of 52 CPs (3.8%, 0.003/100 catheter days) (p.0.05). Arterial bolus triggering succeeded in all attempts; the mean injection pressure was 213.8 psi. Aortic enhancement did not significantly differ between injections via cannulas and TIVPPs (p.0.05). Conclusions: TIVPPs can be implanted with high technical success rates, and are associated with low rates of complications if implanted with sonographic and fluoroscopic guidance. Power injections via TIVPPs are safe and result in satisfying arterial contrast. Conventional ports should be replaced by TIVPPs.

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“…Confirmation of reflux from the injection route has been reported as a safety countermeasure during power injection [3,[9][10][11]. In some reports, the saline test injection was performed manually [2,3,12].…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of the new injection program ‘saline test injection mode’ for use power injector in pediatric contrast CT

Abe

Mizuno

Tani

et al. 2013

Australas Phys Eng Sci Med

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To improve the safety of the use of a power injector for pediatric contrast CT, we newly developed a saline test injection mode for a power injector and investigated its usefulness. We used an injection route and investigated the relationship of the injection pressure to the injection rate of saline and the contrast medium. From this relationship, we investigated it was possible to estimate the change of pressure injection of contrast medium from the pressure change of saline injection. The correlation between the saline test injection pressure and the contrast medium injection pressure was investigated in 64 clinical cases. The detection rate of side effects from the saline test injection was investigated in 473 patients. Regarding the correlation between the injection rate and pressure for both saline and contrast, the pressure rose as the rate increased. The contrast medium injection pressure could be estimated from the correlation observed with saline. The clinical data were obtained had a relationship similar to that with phantom data. The detection rate of side effects from the saline test injection was 4.4 % in the clinical cases. In these cases, examinations were completed by re-establishing an injection route or administering hypnotics. Our results suggest that contrast medium pressure can be estimated from a saline test injection, thus aiding in prediction of the risk of injection abnormality. Reactions to injections could be observed in the present study, facilitating the prevention of examination failure. Countermeasures can be taken against the cause of the reaction, and the examination can be performed after confirming the absence of a reaction to injection. Therefore, a saline test injection may be useful in pediatric contrast CT.

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Power Injection of Contrast Media Using Central Venous Catheters

Cited by 65 publications

References 25 publications

Scan and contrast administration principles of MDCT

Scan and contrast administration principles of MDCT

Totally implantable venous power ports of the forearm and the chest: initial clinical experience with port devices approved for high-pressure injections

Effectiveness of the new injection program ‘saline test injection mode’ for use power injector in pediatric contrast CT

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