Purpose or Case Report: To compare hand versus mechanical administration of intravenous (IV) contrast on the quality of CT pulmonary angiography in the pediatric population.
Methods & Materials: A retrospective IRB approved review of the electronic medical records was performed to identify pediatric patients (< 18 years) with CT pulmonary angiography performed between September 2012 and March 2015. The information obtained included method of contrast administration (hand versus mechanical), IV size/gauge, IV site, amount and type of contrast administered, and rate of administration (ml/sec). Both qualitative and quantitative evaluation of the CT image quality was performed by two pediatric radiologists independently. Analysis of variance using the F-test compared contrast enhancement within the pulmonary arteries in hand versus mechanical administration of IV contrast adjusting for age.
Results: 148 consecutive pediatric patients (77 males, 71 females; mean age 11.1 years, range 8 days old to 17.9 years) were identified during the study period. 29 patients (19.6%, 1.4 years + 1.8 years; range 8 days to 8.1 years) had hand administration of contrast and 119 patients (80.4%, 13.5 years, +3.9 years, range 1.2-17.9 years)had mechanical administration of contrast. The contrast enhancement of the pulmonary arteries was not significantly different between the two IV contrast administration methods at the main pulmonary artery (385 + 141 versus 296 + 109, p = 0.313), right pulmonary artery (385 + 141 versus 291 + 104, p = 0.364) and left pulmonary artery (395 + 149 versus 288 + 102, p = 0.241) adjusting for age.
Conclusions: Diagnostic quality CT pulmonary angiography can be achieved using hand administration of IV contrast in infants and young pediatric patients less than 5 years old.