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Aortic and Hepatic Contrast Enhancement with Abdominal 64-MDCT in Pediatric Patients: Effect of Body Weight and Iodine Dose

¹ Department of Radiology, University of Pittsburgh School of Medicine, 3362 Fifth Ave., Pittsburgh, PA 15213.
² Department of Radiology, Hahnemann University Hospital, Drexel University College of Medicine, Philadelphia, PA.
³ Department of Radiology, Gifu University School of Medicine, Gifu, Japan.
⁴ Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO.

OBJECTIVE. The purpose of our study was to retrospectively evaluate the effect of body weight and iodine dose on aortic and hepatic contrast enhancement in pediatric patients who underwent 64-MDCT of the abdomen and pelvis.

MATERIALS AND METHODS. Eighty-seven consecutive pediatric patients (50 boys and 37 girls; median age, 12.1 years; age range, 3.8–17.6 years) underwent standard abdominopelvic CT with a 64-MDCT scanner. Contrast medium (350 mg I/mL) was injected using a power injector at 2 mL/s followed by 15–20 mL of saline flush. According to our CT protocol, the volume of administered contrast medium was approximately 1.8 mL/kg of body weight, up to the maximum volume of 80 mL. CT scanning was initiated 60 seconds after the start of the contrast medium injection. CT attenuations of the aorta and liver were measured. For each patient, the injected contrast medium iodine mass per body weight index (g I/kg) (hereafter, iodine mass body index) was calculated. Linear regression analysis was performed between iodine mass body index and aortic and hepatic attenuations.

RESULTS. A wide range of patient weights (19–82 kg; mean, 48.6 kg [95% CI, 45.3–51.9 kg]) and contrast volumes (30–80 mL; median, 80.0 mL) were observed. The median attenuations were 149.0 HU (141.0–160.0 HU) for the aorta and 113.5 HU (109.5–120.0 HU) for the liver. Moderately high correlations were observed between iodine mass body index and aortic (Spearman's rho [r_s] = 0.60 [0.45–0.72]; p < 0.001) and hepatic (r_s = 0.60 [0.42–0.70]; p < 0.001) attenuations. The regression formulae for aortic attenuation (58.4 + 176.3 x iodine mass body index [p < 0.001]) and hepatic attenuation (58.7 + 108.5 x iodine mass body index [p < 0.001]) indicate that 1.5 and 1.8 mL/kg (350 mg I/mL) of contrast media are required to achieve 116 and 127 HU, respectively, of contrast-enhanced attenuation in the liver.

CONCLUSION. In our study, using abdominal 64-MDCT in pediatric patients, we found that approximately 1.5 mL/kg, or 0.525 g I/kg, yields 116 HU of hepatic attenuation or 50–55 HU of hepatic enhancement.

Keywords: abdominal CT • contrast agents • CT • IV • pediatric patients

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