Three-Phase Dual Flow Contrast Media Injection Scheme for Low kV Head and Neck CTA in Rabbit Model

Abstract

Background: To evaluate the effect of using a three-phase dual-flow contrast media (CM) injection scheme in low kilovolt (kV) head and neck computed tomography angiography (CTA) in rabbits to provide a theoretical basis for clinical practice. Methods: Thirty rabbits were randomly divided into 3 groups of 10 rabbits each, depending on tube voltage and injection scheme. Group A: Two-phase injection with CM (1.5 mL/kg) at 100 kV. Group B: Two-phase injection with CM (1.5 mL/kg) at 80 kV. Group C: Three-phase injection with CM (1.5 mL/kg × 80%) at 80 kV. Hemodynamic testing on rabbits was performed using an ultrasound device to assess differences between groups. CTA scans were performed to observe the differences in CT (Computed Tomography) values, image quality, radiation dose, and CM dosage in three groups. Finally, laboratory tests and renal pathology were performed to observe the damage of CM. Results: There was no significant difference in hemodynamics between the three groups. In the vessels, there was a decrease in group C versus group B at aortic arch (AA) (p < 0.05). Left superior vena cava (LSVC) was bigger in group C than in groups A and B (p < 0.05). There was no significant difference between three groups in image quality. Groups B and C showed 41% lower radiation dose than A (p < 0.05). For the CM dosage, Group C had CM dosage reduced by 20% compared to groups A and B (p < 0.05). For the laboratory tests result of group B and C, creatinine (Cre) was statistically different at 24 h and 48 h (p < 0.05), and blood urea nitrogen (BUN) showed a difference at the 48th (p < 0.05). Conclusions: Contrast injection scheme with three phases of dual flow in the head and neck can be performed with low kV and significantly reduce intravenous CT values. At the same time, it can also reduce the radiation dose and CM dosage what reduces kidney damage while it ensures image quality.