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Novel connecting tube for saline chaser in contrast-enhanced CT: the effect of spiral flow of saline on contrast enhancement

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Abstract

Objective

To evaluate the effect of a newly developed connecting tube, which generates a spiral flow of saline, on aortic and hepatic contrast enhancement during hepatic-arterial phase (HAP) and portal venous phase (PVP) computed tomography (CT).

Methods

Eighty patients were randomly assigned to one of two protocols: with a new or a conventional tube. The contrast material (600 mgI/kg) was delivered over 30 s; this was followed by the administration of 25 ml saline solution delivered at the same injection rate as the contrast material. Unenhanced and contrast-enhanced CT images of the upper abdomen were obtained. We calculated the changes in the CT number (∆HU) for the aorta during HAP and PVP, and for the liver during PVP. We compared ∆HU between protocols.

Results

The mean ∆HU for the abdominal aorta during HAP was significantly higher with the new tube protocol than with the conventional tube protocol (322 ± 53 vs. 290 ± 53, P < 0.01). There were no significant differences in the mean ∆HU for the abdominal aorta and liver during PVP between the two protocols (P > 0.05).

Conclusion

The new connecting tube increased the effect of a saline chaser and significantly improved aortic enhancement during HAP.

Key Points

• Optimal administration of intravenous contrast material is essential for optimal CT quality.

• A new connecting tube can generate spiral flow, which improves intravenous administration.

• The new connecting tube improved aortic contrast enhancement during the hepatic-arterial phase.

• The new connecting tube increased the effect of a saline chaser.

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References

  1. Kim DJ, Kim TH, Kim SJ et al (2008) Saline flush effect for enhancement of aorta and coronary arteries at multidetector CT coronary angiography. Radiology 246:110–115

    PubMed  Google Scholar 

  2. Schoellnast H, Tillich M, Deutschmann HA et al (2004) Improvement of parenchymal and vascular enhancement using saline flush and power injection for multiple-detector-row abdominal CT. Eur Radiol 14:659–664

    Article  PubMed  Google Scholar 

  3. Schoellnast H, Tillich M, Deutschmann MJ, Deutschmann HA, Schaffler GJ, Portugaller HR (2004) Aortoiliac enhancement during computed tomography angiography with reduced contrast material dose and saline solution flush: influence on magnitude and uniformity of the contrast column. Invest Radiol 39:20–26

    Article  PubMed  Google Scholar 

  4. Haage P, Schmitz-Rode T, Hubner D, Piroth W, Gunther RW (2000) Reduction of contrast material dose and artifacts by a saline flush using a double power injector in helical CT of the thorax. AJR Am J Roentgenol 174:1049–1053

    Article  PubMed  CAS  Google Scholar 

  5. Irie T, Kajitani M, Yamaguchi M, Itai Y (2002) Contrast-enhanced CT with saline flush technique using two automated injectors: how much contrast medium does it save? J Comput Assist Tomogr 26:287–291

    Article  PubMed  Google Scholar 

  6. Behrendt FF, Bruners P, Keil S et al (2010) Effect of different saline chaser volumes and flow rates on intravascular contrast enhancement in CT using a circulation phantom. Eur J Radiol 73:688–693

    Article  PubMed  Google Scholar 

  7. Lee K, Kishimoto M, Shimizu J, Iwasaki T, Miyake Y, Yamada K (2010) Effect of a saline chaser for contrast enhancement of computed tomographic angiography in cattle. Vet Rec 166:137–139

    Article  PubMed  CAS  Google Scholar 

  8. Yoon DY, You SY, Choi CS et al (2006) Multi-detector row CT of the head and neck: comparison of different volumes of contrast material with and without a saline chaser. Neuroradiology 48:935–942

    Article  Google Scholar 

  9. de Monye C, Cademartiri F, de Weert TT, Siepman DA, Dippel DW, van Der Lugt A (2005) Sixteen-detector row CT angiography of carotid arteries: comparison of different volumes of contrast material with and without a bolus chaser. Radiology 237:555–562

    Article  PubMed  Google Scholar 

  10. Behrendt FF, Jost G, Pietsch H et al (2011) Computed tomography angiography: the effect of different chaser flow rates, volumes, and fluids on contrast enhancement. Invest Radiol 46:271–276

    Article  PubMed  Google Scholar 

  11. Schindera ST, Nelson RC, Howle L, Nichols E, DeLong DM, Merkle EM (2008) Effect of varying injection rates of a saline chaser on aortic enhancement in CT angiography: phantom study. Eur Radiol 18:1683–1689

    Article  PubMed  Google Scholar 

  12. Marin D, Nelson RC, Guerrisi A et al (2011) 64-section multidetector CT of the upper abdomen: optimization of a saline chaser injection protocol for improved vascular and parenchymal contrast enhancement. Eur Radiol 21:1938–1947

    Article  PubMed  Google Scholar 

  13. Lee CH, Goo JM, Bae KT et al (2007) CTA contrast enhancement of the aorta and pulmonary artery: the effect of saline chase injected at two different rates in a canine experimental model. Invest Radiol 42:486–490

    Article  PubMed  Google Scholar 

  14. Li H, Tomita Y (1998) An experimental study of swirling flow pneumatic conveying system in a vertical pipeline. J Fluid Eng 120:200–203

    Article  CAS  Google Scholar 

  15. Li H, Tomita Y (1996) An experimental study of swirling flow pneumatic conveying system in a horizontal pipeline. J Fluid Eng 118:526–530

    Article  Google Scholar 

  16. Awai K, Hatcho A, Nakayama Y et al (2006) Simulation of aortic peak enhancement on MDCT using a contrast material flow phantom: feasibility study. AJR Am J Roentgenol 186:379–385

    Article  PubMed  Google Scholar 

  17. Awai K, Hiraishi K, Hori S (2004) Effect of contrast material injection duration and rate on aortic peak time and peak enhancement at dynamic CT involving injection protocol with dose tailored to patient weight. Radiology 230:142–150

    Article  PubMed  Google Scholar 

  18. Bae KT. Intravenous contrast medium administration and scan timing at CT: considerations and approaches. Radiology 256:32–61

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Acknowledgements

There was no direct financial support from industry for this study. This study received the connecting tube from Nemoto-Kyorindo, Tokyo, Japan, the manufacturer of the connecting tube used in this study. K.Y. is an employee of Nemoto-Kyorindo. Y.P. is chief executive officer of EBM, Tokyo, Japan. Y.P. and T.Y have pending and/or awarded patents for the subject matter described in the manuscript and receive royalty income for a patent license from Nemoto-Kyorindo. The authors (M.K, T.N, K.A, T.K, K.H, Y.Y) who were not employees of Nemoto-Kyorindo or EBM had control of data and information that might have presented a conflict of interest.

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Authors and Affiliations

  1. Diagnostic Radiology, Amakusa Medical Center, kameba 854-1, Amakusa, Kumamoto, 863-0046, Japan

    Masafumi Kidoh & Takeshi Nakaura

  2. Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University 1-1-1, Honjo, Kumamoto, 860-8556, Japan

    Masafumi Kidoh, Takeshi Nakaura & Yasuyuki Yamashita

  3. Department of Diagnostic Radiology, Hiroshima University, Hiroshima, Japan

    Kazuo Awai

  4. Sales Division, Nemoto Kyorindo, Tokyo, Japan

    Koji Yuba

  5. Kitasato Institute Hospital, Tokyo, Japan

    Takayuki Kobayashi

  6. Faculty of Science and Engineering, Waseda University, Tokyo, Japan

    Young-Kwang Park & Takanobu Yagi

  7. Department of Surgery, Amakusa Medical Center, Amakusa, Kumamoto, Japan

    Kazunori Harada

Authors
  1. Masafumi Kidoh
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  2. Takeshi Nakaura
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  3. Kazuo Awai
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  4. Koji Yuba
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  5. Takayuki Kobayashi
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  6. Young-Kwang Park
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  7. Takanobu Yagi
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  8. Kazunori Harada
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  9. Yasuyuki Yamashita
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Corresponding author

Correspondence to Masafumi Kidoh.

Electronic supplementary material

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An image obtained by actually imaging the pushed state of the contrast agent using the new connecting tube. A black ink was mixed to the contrast agent. The saline flow rate was 4 ml/s. The pushed state was imaged by 500 frames per second using a high-speed camera. The portion appearing black in Movie 1 was the flow of the contrast agent. As understood from Movie 1, the new connecting tube was able to generate the spiral flow (MPG 2948 kb)

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Kidoh, M., Nakaura, T., Awai, K. et al. Novel connecting tube for saline chaser in contrast-enhanced CT: the effect of spiral flow of saline on contrast enhancement. Eur Radiol 23, 3213–3218 (2013). https://doi.org/10.1007/s00330-013-2923-x

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  • DOI: https://doi.org/10.1007/s00330-013-2923-x

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