Accuracy of predicting and controlling time-dependent aortic enhancement from a test bolus injection

Abstract

Purpose: The purpose of this work was to determine the accuracy of predicting arterial enhancement from peripheral versus central venous test bolus injections at CT angiography (CTA).

Method: In 40 patients with abdominal aortic aneurysms, aortoiliac enhancement profiles were predicted by mathematical deconvolution of the time-attenuation response to a 16 ml test bolus injection. Injection sites were either a cubital vein (n = 20) or a central venous injection site (n = 20). The accuracy of predicting enhancement was quantified as the "off-predicted deviation" (calculated as mean squared differences between observed minus predicted enhancement values) in all patients.

Results: Off-predicted deviation was significantly smaller in the central venous injection group (17 +/- 6 HU) than the peripheral injection group (33 +/- 18 HU) (p < 0.001).

Conclusion: Arterial enhancement at CTA can be mathematically predicted and controlled more accurately if a central venous injection site is used. Automated saline flushing of the veins might improve the accuracy of the mathematical model for peripheral injections.