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Intraosseous contrast administration for emergency computed tomography: A case-control study
OBJECTIVE: The aim of the study was to evaluate the feasibility of intraosseous (i.o.) contrast media injection (CMI) for emergency computed tomography (CT) of severe trauma and the associated image quality compared to intravenous (i.v.) CMI. MATERIALS AND METHODS: The authors retrospectively analys...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6544258/ https://www.ncbi.nlm.nih.gov/pubmed/31150466 http://dx.doi.org/10.1371/journal.pone.0217629 |
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author | Schindler, Philipp Helfen, Anne Wildgruber, Moritz Heindel, Walter Schülke, Christoph Masthoff, Max |
author_facet | Schindler, Philipp Helfen, Anne Wildgruber, Moritz Heindel, Walter Schülke, Christoph Masthoff, Max |
author_sort | Schindler, Philipp |
collection | PubMed |
description | OBJECTIVE: The aim of the study was to evaluate the feasibility of intraosseous (i.o.) contrast media injection (CMI) for emergency computed tomography (CT) of severe trauma and the associated image quality compared to intravenous (i.v.) CMI. MATERIALS AND METHODS: The authors retrospectively analysed objective (contrast-to-noise ratio (CNR)) and subjective (4-point Likert scale) image quality of CTs after i.o. (n = 4, mean age (y) 57.0±11.0) versus i.v. (n = 20, mean age (y) 58.8±4.4) CMI. All patients underwent a native head CT scan, a cerebral CT angiography (CTA) and CTA of the supra-aortic vasculature as well as a chest and abdominal CT scan in the venous phase; one patient with an i.o. access additionally received a CTA of the lower limbs. Electronic patient records have been reviewed to determine i.o. access related complications. RESULTS: Both groups were consistent in age, heart rate, scan parameters including the flow rate of the contrast agent, resulting in comparable radiation dose levels. The image noise and CNR had no significant difference between the two groups. Scoring the delineation of the main vessels after i.o. CMI showed no significant difference to the i.v. group. There were no CT or i.o. access related complications observed. CONCLUSION: The i.o. access is a safe and suitable alternative for emergency CMI in CT. Using established protocols good to very good image quality can be achieved, comparable to i.v. CMI. We show for the first time, that i.o. CMI is also feasible for CTA imaging of the head and neck region as well as of pelvic and leg vessels. |
format | Online Article Text |
id | pubmed-6544258 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-65442582019-06-17 Intraosseous contrast administration for emergency computed tomography: A case-control study Schindler, Philipp Helfen, Anne Wildgruber, Moritz Heindel, Walter Schülke, Christoph Masthoff, Max PLoS One Research Article OBJECTIVE: The aim of the study was to evaluate the feasibility of intraosseous (i.o.) contrast media injection (CMI) for emergency computed tomography (CT) of severe trauma and the associated image quality compared to intravenous (i.v.) CMI. MATERIALS AND METHODS: The authors retrospectively analysed objective (contrast-to-noise ratio (CNR)) and subjective (4-point Likert scale) image quality of CTs after i.o. (n = 4, mean age (y) 57.0±11.0) versus i.v. (n = 20, mean age (y) 58.8±4.4) CMI. All patients underwent a native head CT scan, a cerebral CT angiography (CTA) and CTA of the supra-aortic vasculature as well as a chest and abdominal CT scan in the venous phase; one patient with an i.o. access additionally received a CTA of the lower limbs. Electronic patient records have been reviewed to determine i.o. access related complications. RESULTS: Both groups were consistent in age, heart rate, scan parameters including the flow rate of the contrast agent, resulting in comparable radiation dose levels. The image noise and CNR had no significant difference between the two groups. Scoring the delineation of the main vessels after i.o. CMI showed no significant difference to the i.v. group. There were no CT or i.o. access related complications observed. CONCLUSION: The i.o. access is a safe and suitable alternative for emergency CMI in CT. Using established protocols good to very good image quality can be achieved, comparable to i.v. CMI. We show for the first time, that i.o. CMI is also feasible for CTA imaging of the head and neck region as well as of pelvic and leg vessels. Public Library of Science 2019-05-31 /pmc/articles/PMC6544258/ /pubmed/31150466 http://dx.doi.org/10.1371/journal.pone.0217629 Text en © 2019 Schindler et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Schindler, Philipp Helfen, Anne Wildgruber, Moritz Heindel, Walter Schülke, Christoph Masthoff, Max Intraosseous contrast administration for emergency computed tomography: A case-control study |
title | Intraosseous contrast administration for emergency computed tomography: A case-control study |
title_full | Intraosseous contrast administration for emergency computed tomography: A case-control study |
title_fullStr | Intraosseous contrast administration for emergency computed tomography: A case-control study |
title_full_unstemmed | Intraosseous contrast administration for emergency computed tomography: A case-control study |
title_short | Intraosseous contrast administration for emergency computed tomography: A case-control study |
title_sort | intraosseous contrast administration for emergency computed tomography: a case-control study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6544258/ https://www.ncbi.nlm.nih.gov/pubmed/31150466 http://dx.doi.org/10.1371/journal.pone.0217629 |
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