Aortic enhancement during abdominal CT angiography: Correlation with test injections, flow rates, and patient demographics

OBJECTIVE. The goal of our study was to determine the effect of contrast ma terial injection rate and patient demographic variables on vascular enhance ment for abdominal CT angiography and compare test injection results with a ctual patterns of vascular enhancement. SUBJECTS AND METHODS. One hundred twenty-five patients underwent abdominal CT angiography. For each patient, CT attenuation values (Hounsfield units) of the aorta were determined before and after IV contrast administration, e very 3 sec between 21 and 60 sec. A peak aortic enhancement value and the t ime needed to reach. peak and aortic enhancement thresholds of 150 and 200 H were determined. All patients received 150 mi of nonionic con: trast mate rial at 3 ml/sec in 25 patients and 4 ml/sec in 100 patients. A test inject ion of 15 ml was used to compute a scan delay in 46 patients. Patient age, sex, weight, injection rate, and test injection results were compared with vascular enhancement patterns. RESULTS. For the 125 patients, the mean aortic enhancement at each time poi nt was greater than 150 Il. Patient weight was inversely correlated (r(2) = -.62) with aortic enhancement. The test injection did not accurately predi ct actual aortic enhancement peak value or time. Test injection delay time was significantly correlated with time to reach aortic enhancement threshol ds of 150 and 200 H. The 4 ml/sec rate resulted in a higher peak aortic enh ance ment (320 +/- 58 H versus 281 +/- 49 H) (mean +/- SD, p < .01) that wa s reached quicker than with the 3 ml/sec injection rate (45 +/- 5 sec versu s 52 +/- 5 sec) (p < .01). Injecting at 4 ml/sec resulted in greater aortic enhancement values at 24-45 sec, whereas 3 ml/sec produced significantly b etter aortic enhancement at 54-60 sec. CONCLUSION. The test injection correlated better with time to reach specifi c aortic enhancement thresholds than with time to peak aortic enhancement. For a given amount of contrast material, faster injection rates resulted in greater vascular enhancement that occurred earlier.