Clinical Utility of a New Protocol Using Saline Test Injection and a Leak Detection Sensor to Reduce the Frequency...

To evaluate whether our new protocol that uses a saline test injection and a leak detection sensor (LDS) reduces the frequency and amount of contrast media (CM) extravasation during the intravenous CM administration for CT.

This retrospective study included 20,342 patients who underwent CECT at our hospital from March 2021 to November 2021 (old protocol, direct patient observation, and CM injection pressure monitoring, n=10,529) and from March 2024 to November 2024 (new protocol, old protocol plus saline test injection, and the LDS attachment, n=9813). We compared the frequency and the volume of extravasation between the 2 protocols using the Fisher exact test and the Mann-Whitney U test. We also evaluated the accuracy of the LDS.

Extravasation occurred in 51 patients (age 72.1±12.2 y, 33 men) under the old protocol and in 26 patients (age 73.6±9.0 y, 17 men) with the new protocol. The overall frequency of extravasation and the number of patients with an extravasation volume of at least 20 mL were significantly lower with the new protocol than the old protocol (0.48% vs. 0.26%; 0.16% vs. 0.03% all, P <0.01). The extravasation volume was significantly reduced with the new protocol (14 vs. 6 mL, P <0.01). The sensitivity of the LDS to detect extravasation of 3, 5, 10, and 15 mL was 50%, 88%, 93%, and 100%, respectively; specificity was 99% for all.

Our new protocol reduced the frequency and dose of CM extravasation.