Simplified split-bolus intravenous contrast injection technique for pediatric abdominal CT : comparison of image quality and radiation dose with that of single bolus technique

Abstract

Objectives: To investigate image quality and radiation dose for pediatric abdominal CT using a split-bolus intravenous contrast injection technique. Methods: This retrospective study included two groups of pediatric abdominal CT with the split-bolus (Split group) or the single bolus (Control group) intravenous contrast injection technique. Radiation dose, image quality and diagnostic accuracy were evaluated. Results: Between the Split group (n = 114) and Control group (n = 100), mean age (10.6 vs. 9.9 years, p = 0.344) and body weight (36.6 vs. 33.9 kg, p = 0.284) were not different. On age-matched comparison for subgroup analysis with 60 patients in each group, the mean effective dose was lower in the Split group (2.46 vs. 2.85 mSv, p = 0.002). Noise level was lower in the Split group in aorta (17.8 vs. 19.9, p < 0.001), liver (11.1 vs. 14.2, p < 0.001), and portal vein (17.4 vs. 19.8; p = 0.014). Nine studies (8%) in the Split group and 12 studies (12%) in the Control group were diagnostically suboptimal. Conclusion: The split-bolus intravenous contrast injection technique is a simple method to obtain adequate and homogeneous enhancement without need for bolus tracking radiation dose in pediatric abdominal CT.