Rationale and objectives: The authors develop and compare contrast material injection protocols suitable for hepatic helical computed tomography.
Methods: One hundred twenty-one patients who underwent contrast-enhanced computed tomography (CT) of the liver with spiral CT imaging were evaluated for enhancement of the liver parenchyma and for post-enhancement attenuation of the aorta and portal vein with iohexol. Patients were assigned randomly to five protocols with different flow rates, volume of contrast material, and scan delays.
Results: Mean parenchymal contrast enhancement was statistically significantly higher with protocol 5 (biphasic injection of 100 mL of iohexol 300 (g/100 mL) at a flow rate of 1.5 mL/second followed by 25 mL at 2 mL/second; total iodine load = 37.5 g, with a scan delay of 70 seconds). The highest aortic enhancement and the second highest portal vein enhancement were obtained with this protocol.
Conclusion: The authors suggest an easily tolerated injection protocol able to ensure high parenchymal liver enhancement and satisfactory aortic and portal vein enhancement. This protocol includes a long scan delay (70 seconds), biphasic low flow injection rate, and a relatively low iodine load.