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

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).

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.

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).

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.