Giulia A. Zamboni MD, Presenter: Nothing to Disclose

Sofia Gourtsoyianni MD, Abstract Co-Author: Nothing to Disclose

Janneth Yolanda Romero MD, Abstract Co-Author: Nothing to Disclose

Vassilios D. Raptopoulos MD, Abstract Co-Author: Nothing to Disclose

To evaluate the routine use of split-bolus IV contrast administration in patients undergoing abdominal CT for non-traumatic abdominal pain.

We retrospectively reviewed 157 consecutive Emergency Department patients with abdominal pain who underwent abdominal CT with split-bolus administration of 130ml IV contrast: first 50ml followed by 80ml 3-minutes later. Patients were scanned with a 60-second delay from the second bolus on 64-row MDCT, with 0.625mm collimation and 5mm axial, coronal and sagittal reformatted image display. Two radiologists reviewed the images and graded by consensus (5-point scale: 1=none to 5=excellent) parenchymal and vascular enhancement, and measured attenuation of the liver and spleen parenchyma, renal cortex, medulla and pelvis, aorta, portal vein, superior mesenteric artery and vein. Attenuation values were compared to the scans of 21 patients who had conventional single-bolus injections and dual-phase (portal venous and 3-min delayed) scanning.

The cause of abdominal pain was identified in 72 patients. The split-bolus provided a combined vascular, parenchymal and excretory phase. The major vessels, liver and spleen parenchyma enhanced well and homogeneously with attenuation values not significantly different from the dual-phase scans: mean aorta 191HU, portal vein 169HU, liver 116HU and spleen 130HU. Median grade for vascular evaluation was 5 and for renal cortex and spleen parenchyma 4 and 5, respectively. Mean renal medullary, cortex and pelvis attenuation were 197HU, 152HU, and 722HU, respectively.

Split-bolus IV contrast administration is an efficient and rapid exam, informative of organ and vessel abnormalities, that can eliminate the need for delayed scanning in patients with abdominal pain.

Split bolus iv contrast administration in CT for non-traumatic abdominal pain is well tolerated, informative of organ and vessel abnormalities, and eliminates the need for delayed scanning.

Zamboni, G, Gourtsoyianni, S, Romero, J, Raptopoulos, V, Split-Bolus CT for Patients with Abdominal Pain.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9012251.html