Publication details

Computed Tomography Angiography With High Flow Rates An In Vitro and In Vivo Feasibility Study

Authors

MIHL Casper KOK Madeleine WILDBERGER Joachim E. TUREK Jakub MUEHLENBRUCH Georg DAS Marco

Year of publication 2015
Type Article in Periodical
Magazine / Source Investigative Radiology
MU Faculty or unit

Faculty of Medicine

Citation
Doi http://dx.doi.org/10.1097/RLI.0000000000000153
Field Other medical specializations
Keywords attenuation; cannula; computed tomography; contrast media; flow injection analysis; injection; phantom
Description Objective The aims of this study were to test high-flow application of contrast media (CM) using novel high-flow needles and to assess injection- and flow-related parameters in a circulation phantom and in an in vivo population. Materials and Methods A circulation phantom simulating physiological parameters was used. Preheated CM (300 mg/mL) was injected at flow rates varying between 5 and 15 mL/s through a novel 18-gauge high-flow intravenous injection needle. In addition, feasibility of these high-flow needles was tested with administration of flow rates of 9 mL/s in 20 patients referred for pre-transcatheter aortic valve implantation assessment. Injection parameters (eg, peak pressures, peak flow rates) in both phantom and in vivo setup were continuously monitored by a data acquisition program. Attenuation at predefined levels of the aorta (eg, aortic root to common femoral arteries) was measured in all patients to determine clinical applicability. Results In the phantom setup, injection rates up to 15 mL/s were feasible. An enhancement plateau was reached at 11 mL/s (464 [20] HU). In patients, no pressure- or flow-related complications (eg, extravasation) were recorded (mean [SD] peak pressure, 154 [8] psi; mean [SD] peak flow rate, 9.2 [0.1 mL/s; range, 9.1-9.6]). Diagnostic attenuation values were reached at all predefined levels of the aorta (330.8 [113.1] HU to 622.9 [81.5] HU). Conclusions These results indicate that injections with 9 mL/s using high-flow injection needles are safe. The pressure limit of 325 psi was not reached, and the injections resulted in diagnostic attenuation values. Using this dedicated needle, high flow rates should not be considered a drawback for CM application in routine CT angiography examinations.

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