Background: Intravenous (IV) iodine-based contrast agents are administered during computed tomography (CT) examination to enhance the density differences between lesions and surrounding parenchyma, which is important for lesion characterization, and to demonstrate vascular anatomy and vessel patency. Quality of contrast enhancement has a significant influence on diagnostic interpretation and subsequent management. In this study, we assessed the quality of portal venous phase abdominal CT scans performed with a manual injection of a fixed dose of contrast, which is the routine practice at Tikur Anbessa Specialized Hospital (TASH). The effect of age and sex was also assessed.
Method: A hospital-based retrospective review was performed to identify patients who have had a precontrast and postcontrast abdominal CT scan from November 4, 2020, to September 30, 2022. All patients with abdominal CT scans having precontrast and portal venous phase scans were included in the study. All CT scans were reviewed by the principal investigator and the quality of contrast enhancement was assessed.
Results: In this study, there were a total of 379 patients. The mean hepatic attenuations in precontrast and portal venous phase scans were 59.05 ± 6.69 HU and 103.73 ± 12.84 HU. The proportion of scans with less than 50 HU enhancement was 68% (n = 258). There was a significant association between age and sex with contrast enhancement.
Conclusion: The hepatic contrast enhancement pattern of abdominal CT scan at the study institution reveals a concerning degree of image quality. This is evidenced by the high number of suboptimal contrast enhancement indices and the highly variable enhancement patterns across different patients. This can have a negative impact on the diagnostic performance of CT imaging and can adversely affect the management. Furthermore, both sex and age affect the pattern of enhancement.
Background: There is great variability between centers regarding contrast injection protocols. They should only be injected if they can provide useful information for diagnosis with the necessary and sufficient quantity of iodine. We wanted to know through this study if the use of iodinated contrast media is optimised in abdominal CT scans performed for cancer assessment in Lomé.
Materials and methods: It was a cross-sectional, descriptive, and analytical study with a prospective collection over a period of 6 months in three CT units in Lomé. It involved abdominal CT scans performed for oncological evaluation. Data were reported as the mean ± standard deviation. The Pearson correlation coefficient, ANOVA, chi-square, and the Fisher test were used.
Results: A total of 218 examinations were recorded. The female sex represented 56.88% of the patients. The mean age was 50.92 ± 15.78 years. The mean weight was 70.46 ± 15.23 kg. The mean BMI was 24.91 ± 5.32 kg/m2. The examinations were performed with a voltage of 120 kV in 195 cases (89.45%). The mean dose of injected iodine was 0.42 ± 0.09 gI/kg with a dose of 0.40 gI/kg at 80 kV and 0.45 gI/kg at 130 kV. The mean injection rate was 2.90 ± 0.34 mL/s. The mean injected volume was 83.19 ± 7.29 mL. The mean duration of the injection was 30.60 ± 7.39 s. The mean iodine delivery rate was 0.98 ± 0.17 gI/s. There was no saline injection in 152 cases (69.72%). Liver contrast enhancement was satisfactory in 94.5% of cases. There was a strong negative linear correlation between the dose of injected iodine and weight.
Conclusions: Optimization guidelines for the use of iodinated contrast media are not always applied. Therefore, monitoring and benchmarking programmes for iodinated contrast injection protocols that involve all radiology personnel should be implemented.
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