OBJECTIVE: We evaluated the relationship between image degradation due to the reflux of contrast agent into the major neck veins and use of a left-arm injection site during computed tomographic (CT) angiography of the carotid arteries. METHODS: A total of 364 patients underwent 4-section carotid CT angiography performed with an injection into the right (n = 183) or left (n = 181) arm. We calculated the volume of refluxed contrast medium and measured the retrosternal distance measured as the shortest distance between the sternum and the arch or its branches. Nine patients underwent follow-up CT angiography weeks later by using the side of injection not used before for comparison. RESULTS: The amount of refluxed contrast medium was greater with left-arm injection than with right-arm injection (P < 0.001). With left-arm injection, the volume was significantly correlated with the retrosternal distance (r = -0.514, P < 0.001), even after we adjusted for age and sex in the linear regression model (P < 0.001). Five of the 9 patients who received injections in both arms had no reflux of contrast medium, whereas 4 patients had obvious reflux after left-arm but not right-arm injection. CONCLUSION: Normal compression of the left brachiocephalic vein due to a developmental decreased retrosternal space may degrade carotid CT angiograms because of reflux of contrast material into the cervical veins. This degradation can be avoided if right-arm injection is used.
OBJECTIVE: We evaluated the relationship between image degradation due to the reflux of contrast agent into the major neck veins and use of a left-arm injection site during computed tomographic (CT) angiography of the carotid arteries. METHODS: A total of 364 patients underwent 4-section carotid CT angiography performed with an injection into the right (n = 183) or left (n = 181) arm. We calculated the volume of refluxed contrast medium and measured the retrosternal distance measured as the shortest distance between the sternum and the arch or its branches. Nine patients underwent follow-up CT angiography weeks later by using the side of injection not used before for comparison. RESULTS: The amount of refluxed contrast medium was greater with left-arm injection than with right-arm injection (P < 0.001). With left-arm injection, the volume was significantly correlated with the retrosternal distance (r = -0.514, P < 0.001), even after we adjusted for age and sex in the linear regression model (P < 0.001). Five of the 9 patients who received injections in both arms had no reflux of contrast medium, whereas 4 patients had obvious reflux after left-arm but not right-arm injection. CONCLUSION: Normal compression of the left brachiocephalic vein due to a developmental decreased retrosternal space may degrade carotid CT angiograms because of reflux of contrast material into the cervical veins. This degradation can be avoided if right-arm injection is used.
Authors: N Takeyama; Y Ohgiya; T Hayashi; T Takahashi; D Takasu; J Nakashima; K Kato; Y Kinebuchi; T Hashimoto; T Gokan Journal: Br J Radiol Date: 2010-11-02 Impact factor: 3.039
Authors: R Zivadinov; R Galeotti; D Hojnacki; E Menegatti; M G Dwyer; C Schirda; A M Malagoni; K Marr; C Kennedy; I Bartolomei; C Magnano; F Salvi; B Weinstock-Guttman; P Zamboni Journal: AJNR Am J Neuroradiol Date: 2011-04-07 Impact factor: 3.825
Authors: M Tamizur Rahman; Sean K Sethi; David T Utriainen; J Joseph Hewett; E Mark Haacke Journal: Magn Reson Imaging Date: 2013-07-12 Impact factor: 2.546