Imaging Pearls ❯ Contrast ❯ Contrast Volumes and Injection Rate
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- “Although 22-gauge catheters may be able to tolerate flow rates up to 5 ml/sec, a 20-gauge or larger catheter is preferable for flow rates of 3 ml/sec or higher. An antecubital or large forearm vein is the preferred venous access site for power injection. If a more peripheral (e.g., hand or wrist) venipuncture site is used, a flow rate of no greater than 1.5 ml/sec may be more appropriate.”
ACR Manual on Contrast Media
Version 9 (2013)
- “ There is variability in the size of the smallest-gauge catheter used for power injection. Forty nine percent (40/81) report a 22-guage angiocatheter is the smallest catheter used with a power injector, although up to 33% (27/81) of responders use a power injector for 24-guage angiocatheters, and this practice is supported in the literature.”
Practice Patterns for the Use of Iodinated IV Contrast Media for Pediatric CT Studies: A Survey of the Society for Pediatric Radiology
Callahan MJ et a.
AJR 2014;202:872-879 - “ Roughly half of responders routinely administer IV contrast agents at 2.0 mL/s for contrast enhanced studies of the neck, chest, and abdomen/pelvis. Although most responders use 2.0 mL/s for routine contrast enhanced head CT studies, this examination had the most variability of IV contrast media injection rates.”
Practice Patterns for the Use of Iodinated IV Contrast Media for Pediatric CT Studies: A Survey of the Society for Pediatric Radiology
Callahan MJ et a.
AJR 2014;202:872-879
- "In our study, using abdominal 64-MDCT in pediatric patients, we found that approximately 1.5 mL/kg, or 0.525 g l/kg, yields 116 HU of hepatic attenuation or 50-55 HU of hepatic enhancement."
Aortic and Hepatic Contrast Enhancement with Abdominal 64-MDCT in Pediatric Patients: Effect of Body Weight and Iodine Dose
Bae KT et al
AJR 2008; 191:1589-1594 - "Approximately 0.5 g I/kg is needed to achieve the maximum hepatic enhancement of 50 HU; that is, 35 g I for a 70-kg patient."
Aortic and Hepatic Contrast Enhancement with Abdominal 64-MDCT in Pediatric Patients: Effect of Body Weight and Iodine Dose
Bae KT et al
AJR 2008; 191:1589-1594 - "In general, 50 HU is considered to be a diagnostically appropriate level of hepatic enhancement for abdominal CT in adult patients."
Aortic and Hepatic Contrast Enhancement with Abdominal 64-MDCT in Pediatric Patients: Effect of Body Weight and Iodine Dose
Bae KT et al
AJR 2008; 191:1589-1594 - "The administration of a total iodine dose of 525 mg or more per kilogram of body weight is desirable for the good or excellent depiction of hypervascular HCC, although the administration of 450 mg I/kg of body weight can depict hypervascular HCC."
Optimal Contrast Dose for Depiction of Hypervascular Hepatocellular Carcinoma at Dynamic 64-MDCT
Yanaga Y et al.
AJR 2008; 190:1003-1009
(Omnipaque-350 350 mg/ml of iodine so to get 525 mg iodine you need 150 ml or so) - "Plasma iso-osmotic iodine based contrast media used at commercially available concentrations have superior attenuation and nephrotoxic profiles compared with equal volumes of hyperosmotic nonionic 0.5-1.0 mol/L gadolinium based contrast media when performing renal arteriographic procedures."
Iodixinal 320 Results in Better Renal tolerance and Radiodensity than Do Gadolinium-based Contrast Media:Arteriography in Ischemic Porcine
Elmstahl B et al.
Radiology 2008;247:88-97