Related Experiment Video
Updated: Apr 7, 2026
A Multicenter MRI Protocol for the Evaluation and Quantification of Deep Vein Thrombosis
Published on: June 2, 2015
Quality of abdominal computed tomography angiography: hand versus mechanical intravenous contrast administration in
Rama S Ayyala1, David Zurakowski2, Edward Y Lee3
1Department of Radiology, Boston Children's Hospital and Harvard Medical School, 300 Longwood Ave., Boston, MA, 02115, USA.
Insights
Diagnostic-quality abdominal CT angiography is achievable in pediatric patients using hand-injected intravenous contrast. This method ensures adequate contrast enhancement, comparable to mechanical administration, especially in younger children.
Area of Science:
- Radiology
- Pediatric Imaging
- Vascular Imaging
Background:
- Abdominal CT angiography is vital for pediatric vascular conditions.
- Direct comparison of hand vs. mechanical IV contrast in pediatric abdominal CT angiography is lacking.
Purpose of the Study:
- To compare the image quality of pediatric abdominal CT angiography using hand versus mechanical IV contrast administration.
Main Methods:
- Retrospective review of 46 pediatric patients (≤18 years) undergoing abdominal CT angiography.
- Evaluation of qualitative and quantitative image quality, including contrast enhancement (Hounsfield units) in the abdominal aorta.
- Comparison between hand (n=16) and mechanical (n=30) contrast administration groups, adjusted for age.
Main Results:
- All studies were of diagnostic quality (qualitative score ≥3 and >150 HU).
- No significant difference in aortic contrast enhancement between hand and mechanical administration at celiac axis or IMA levels (P > 0.05).
- Hand administration group included younger children (mean age 1.7 years) compared to mechanical group (mean age 10.2 years).
Conclusions:
- Diagnostic-quality abdominal CT angiography is feasible with hand-injected IV contrast in infants and young children (≤5 years).
- Hand injection provides comparable contrast enhancement to mechanical methods in pediatric abdominal CT angiography.
Background:
Abdominal CT angiography has been increasingly used for evaluation of various conditions related to abdominal vasculature in the pediatric population. However, no direct comparison has evaluated the quality of abdominal CT angiography in children using hand versus mechanical administration of intravenous (IV) contrast agent.
Objective:
To compare hand versus mechanical administration of IV contrast agent in the quality of abdominal CT angiography in the pediatric population.
Materials And Methods:
We retrospectively reviewed the electronic medical record to identify pediatric patients (≤18 years) who had abdominal CT angiography between August 2012 and August 2013. The information obtained includes: (1) type of administration of IV contrast agent (hand [group 1] versus mechanical [group 2]), (2) size (gauge) of IV catheter, (3) amount of contrast agent administered and (4) rate of contrast agent administration (ml/s). Two reviewers independently performed qualitative and quantitative evaluation of abdominal CT angiography image quality. Qualitative evaluation of abdominal CT angiography image quality was performed by visual assessment of the degree of contrast enhancement in the region of interest (ROI) based on a 4-point scale. Quantitative evaluation of each CT angiography examination was performed by measuring the Hounsfield unit (HU) using an ROI within the abdominal aorta at two levels (celiac axis and the inferior mesenteric artery) for each child. Analysis of variance (ANOVA) using the F-test was applied to compare contrast enhancement within the abdominal aorta at two levels (celiac axis and inferior mesenteric artery) between hand administration and mechanical administration of IV contrast methods with adjustment for age.
Results:
We identified 46 pediatric patients (24 male, 22 female; mean age 7.3 ± 5.5 years; range 5 weeks to 18 years) with abdominal CT angiography performed during the study period. Of these patients, 16 (35%; 1.7 ± 2.2 years; range 5 weeks to 5 years) had hand administration of IV contrast agent and 30 (65%; 10.2 ± 4.2 years; range 4-18 years) had mechanical administration of IV contrast agent. All 46 abdominal CT angiography studies were of diagnostic quality based on qualitative evaluation (all ≥3). All abdominal CT angiography studies from both groups showed diagnostic quality of contrast enhancement (>150 HU) at both the celiac axis and the inferior mesenteric artery (IMA) levels. The contrast enhancement of the abdominal aorta was not significantly different between the IV contrast administration methods at either the celiac axis level (360 ± 158 vs. 353 ± 116, P = 0.24) or the IMA level (340 ± 140 vs. 351 ± 90, P = 0.27), adjusting for age.
Conclusion:
Diagnostic-quality abdominal CT angiography can be achieved using hand administration of IV contrast agent in infants and young children (≤5 years).
Related Concept Videos
01:27Imaging Studies III: Computed Tomography
01:28Imaging Studies for Cardiovascular System V: CT
01:19Imaging Studies VII: Vascular Imaging
01:30Radiological Investigation I: X-ray and CT
01:10Computed Tomography
The technique was invented in the 1970s and is based on the principle that as X-rays pass through the body, they are absorbed or reflected at different levels. In the technique, a patient lies on a motorized platform while a computerized axial tomography (CAT) scanner rotates...
01:14Imaging Studies I: CT and MRI
Description of the Procedures
Computed Tomography (CT) scan:
Computed Tomography (CT) scans use X-ray technology to generate detailed images of bones, organs, and tissues. During the scan, the patient lies on a moving table...