Keywords:
Interventional vascular, Neuroradiology brain, Digital radiography, CT, Fluoroscopy, Technical aspects, Computer Applications-General, Contrast agent-intravenous, Tissue characterisation, Ischaemia / Infarction, Haemodynamics / Flow dynamics
Authors:
J. Caroff1, P. Jittapiromsak2, C. Aubé1, D. Ruijters3, N. Benachour2, L. SPELLE2, J. Moret2; 1Angers/FR, 2Clichy/FR, 3Best/NL
DOI:
10.1594/ecr2013/C-1493
Results
Time intensity curves analyze was possible in every case.
20 patients were explored using central venous injections; 10 with the 72/72 protocol and 10 with the 72/20 protocol.
4 patients were explored using peripheral injections (Table 1).
|
|
Number of patients
|
Average age
|
Aneurysm / AVM
|
|
Central 72/72
|
10
|
46
|
7 / 3
|
|
Central 72/20
|
10
|
35
|
6 / 4
|
|
Peripheral 72/72
|
4
|
43
|
1 / 3
|
Table 1.
Injection protocols.
There were no statistical differences between mean peak values of the three different protocols (Central 72/72 = 228,
Central 72/20 = 196,
Peripheral 72/72 = 201).
With central injections,
mean lengths of the steady state were respectively 9.2 +/- 1.5 seconds (range 5.9 – 11.2) and 9.9 +/- 1.3 seconds (range 7.6 – 11.9) for the 72/72 and 72/20 protocols.
With peripheral injections it was 8.2 +/- 0.9 seconds (range 6.9 – 8.9).
Central venous injections with the 72/20 protocol are associated with a longest mean steady state.
Mean differences are 0.7 second compared with the 72/72 protocol,
and 1.7 second compared with peripheral injections,
but no statistical difference has been shown.
The central 72/20 protocol is also associated with less timing variation from injection to steady state,
especially when compared with peripheral injections.
Mean delays are respectively 21.5 seconds versus 28.4 seconds and standard deviations are 2.0 seconds versus 5.9 seconds.
When using peripheral access,
the delay between injection and the beginning of the steady state was nearly 7 seconds later than with central injections.
This is logical and corresponds to the time the contrast agent goes from the forearm to the right atrium (Table 2).
|
|
Length
|
Delay
|
Peak Value
|
|
Central 72/20
|
9.9 +/- 1.3 s
|
21.5 +/- 2.0 s
|
196
|
|
Central 72/72
|
9.2 +/- 1.5 s
|
20.0 +/- 2.8 s
|
228
|
|
Peripheral 72/72
|
8.2 +/- 0.9 s
|
27.2 +/- 5.0 s
|
201
|
Table 2.
Characteristics of the steady state.
When considering central venous injections,
there was a significant agreement between the two readers regarding the timing determination of full opacification of venous sinuses according to concept of the “bolus watching” technique (correlation coefficient r = 0.78; p < 0.005).
Average timing from readers and the measured steady state’s delay were correlated (r = 0.75; p < 0.005),
the mean delay from readers was shorter than the delay measured on time intensity curves but without a statistically significant difference (20.8 seconds versus 21.8 seconds; p = 0.24).
