Uniform vascular contrast enhancement and reduced contrast medium volume achieved by using exponentially decelerated contrast material injection method

PURPOSE: To investigate in computed tomographic (CT) angiography whether an exponentially decelerated contrast medium injection, as compared with a standard constant-rate injection, can facilitate uniform vascular contrast enhancement with a reduced contrast material volume. MATERIALS AND METHODS: CT angiography of the abdominal aorta was performed in 46 subjects by using an exponentially decelerated injection method: 134 mL of contrast medium was injected for 40 seconds, starting at 4.0 mL/sec and decreasing exponentially to 2.7 mL/sec by the end of the injection. Twenty-one of these subjects also underwent CT angiography with a constant-rate injection: 160 mL of contrast medium was injected for 40 seconds at a constant rate of 4 mL/sec. Time-enhancement curves and the magnitude of peak vascular enhancement were measured. Enhancement uniformity was evaluated by using three indexes: (a) duration of contrast enhancement achieved within 80% of the peak (80% DCE), (b) SD of the normalized contrast enhancement (SDNCE) measured from the beginning of spiral CT scanning to the time when the enhancement decreased to a level lower than the beginning level, and (c) slope of the enhancement curve calculated by using linear regression analysis. RESULTS: Exponentially decelerated injection resulted in more uniform enhancement. Mean values generated by using exponentially decelerated versus constant-rate injection in 21 paired comparisons were, respectively, 30.8 seconds ± 5.0 versus 22.6 seconds ± 7.6 for 80% DCE, 0.052 ± 0.017 versus 0.086 ± 0.031 for SDNCE, and 0.47 HU/sec ± 0.70 versus 2.27 HU/sec ± 0.87 for slope (P < .001 for all indexes). Compared with the peak enhancement resulting from the constant-rate injection, that resulting from the exponentially decelerated injection was reduced by a mean of 17.2% ± 10.0. CONCLUSION: Uniform vascular contrast enhancement and reduced contrast medium volume, which are desirable in CT angiography, can be achieved with exponentially decelerated injection.