Comparison of COMPUTED TOMOGRAPHY Image Quality Using Intravenous vs. Intraosseous Contrast Administration in Swine

Area of Science:

• Medical Imaging
• Emergency Medicine
• Radiology

Background:

• Vascular access is critical for administering medications, fluids, and contrast agents in trauma patients.
• Peripheral intravenous (IV) cannulation is standard, but can be difficult or impossible in some cases.
• Intraosseous (IO) access offers an alternative for resuscitation but its utility for contrast enhancement in CT has not been established.

Purpose of the Study:

• To evaluate the efficacy of intraosseous (IO) contrast agent administration for enhanced computed tomography (CT) imaging in trauma protocols.
• To compare the diagnostic quality of CT scans using IO versus IV contrast delivery.

Main Methods:

• A crossover study was conducted in mature mini-swine comparing peripheral IV and IO contrast administration routes.
• Intraosseous access was established in the proximal humerus, confirmed fluoroscopically.
• Animals underwent sequential trauma-protocol CT scans with randomized contrast administration routes (IV or IO), with a washout period in between.

Main Results:

• All CT images successfully administered via IO contrast showed adequate enhancement.
• Two IV contrast administrations resulted in inadequate enhancement, as assessed by blinded radiologists.
• Two instances of failed IO needle placement and one case of contrast extravasation occurred.

Conclusions:

• Intraosseous contrast administration via the proximal humerus yielded adequate enhancement for trauma-protocol CT imaging in this swine model.
• IO contrast delivery is a promising alternative when IV access is delayed, warranting further investigation for clinical application.
• This technique could improve the speed and efficiency of diagnostic imaging in critical trauma scenarios.