Enhance Study Quality

With Saline

Improve study quality, lower costs and reduce streaking in the chest and neck with saline

 

Proper use of power-injected saline in CT leads to better, and more accurate study results.

The use of nonionic contrast agents is quickly becoming mainstream. These agents are often preferred because they are tolerated better by patients and because the complications associated with contrast extravasation tend to be less severe.

The downside of using these agents is their nephrotoxic effects and their cost. This has forced radiologists to come up with ways to minimize the overall volume of contrast administered.1

These advances have prompted research into how to consistently administer the “optimum bolus” of intravenous contrast to maximize contrast enhancement and minimize dosage, all within the confines of shorter scan times.

The shape of injected contrast bolus can be tailored to achieve a desired enhancement pattern.2 Contrast medium is generally administered at a constant injection rate (uniphasic rate) injection protocol.

The second most commonly utilized injection bolus shape is a biphasic-rate injection, which is a fast constant-rate injection followed by a slow constant-rate injection.2

 

Pre-Contrast Test Bolus of Saline Plus Saline Flush

 

A test bolus injection of saline creates a tight, more compact, bolus,1,2 helps achieve uniform vascular enhancement2,3 and prevents a decrease in contrast material flow.4

With the increasing clinical applications of CTA and double-barrel CT contrast injectors, post-contrast saline flush has become widely accepted in CT imaging to improve the efficiency of contrast medium utilization and may reduce the iodine dose without negatively affecting the level of contrast enhancement.

In order to deliver all of the contrast from the venous circulation into the heart in one efficient, tight and coherent bolus, use of saline flush is recommended.1

In fact, several studies have demonstrated that, depending on the type of examination—abdominal, thoracic or CT angiographic—if the saline flush technique is used, approximately 15 to 50 mL of contrast material can be saved.1

A saline flush can permit optimal adjustment of contrast bolus geometry,1-3 reduced pooling of contrast in arm veins,1 decreased streak artifact,1,5 and the ability to reduce iodine dose.2,3

This saline flush pushes the tail of the injected contrast medium bolus into the central blood volume and so makes use of contrast medium that would otherwise remain unused in the injection tubing and peripheral veins.2

Therefore, a saline flush increases the efficiency of contrast medium utilization and the level of contrast enhancement. Additional advantages of a saline flush include:

      • improved bolus geometry as a result of reduced intravascular contrast medium dispersion,
      • reduced streak artifact from dense contrast medium in the brachiocephalic vein and superior vena cava on thoracic CT studies, and
      • increased hydration to reduce contrast-induced nephrotoxicity

Injection of contrast material followed by a saline solution bolus using a double-syringe injector allows a 20% reduction of contrast material to 60 mL with a similar degree of enhancement.1

 

References:
1. Auler MA, Heagy T, Aganovic L, Brothers R, Costello P, and Schoepf UJ. Saline chasing technique with dual-syringe injector systems for multi-detector row computed tomographic angiography: rationale, indications, and protocols. Curr Probl Diagn Radiol. 2006 Jan-Feb;35(1):1–11.
2. Bae KT. Optimization of contrast enhancement in thoracic MDCT. Radiol Clin North Am. 2010 Jan; 48(1): 9–29.
3. Bae KT. Intravenous contrast medium administration and scan timing at CT: considerations and approaches. Radiology. 2010 Jul; 256(1): 32–61.
4. Cademartiri F, van der Lugt A, Luccichenti G, Pavone P, and Krestin GP. Parameters affecting bolus geometry in CTA: a review. J Comput Assist Tomogr. 2002 Jul–Aug; 26(4): 598–607.
5. Haage P, Schmitz-Rode T, Hübner D, Piroth W, and Günther RW. Reduction of contrast material dose and artifacts by a saline flush using a double power injector in helical CT of the thorax. AJR Am J Roentgenol. 2000 Apr; 174(4): 1049–1053.
The views, information, or opinions expressed in the video(s) or article(s) above are solely those of the individuals involved and do not necessarily represent those of Bracco Diagnostics Inc. (“BDI”). The primary purpose of this video(s) or article(s) is to educate and inform. This information does not constitute medical or other professional advice or services.

EmpowerCTA®+ Injector System

Caution: Federal law restricts this device to sale by or on the order of a physician.

INDICATIONS:

The EmpowerCTA®+ Injector System is indicated for the vascular administration of contrast and flushing media in conjunction with computed tomography (CT) scanning of the body with an optional interface to a CT scanner and an optional calculator for glomerular filtration rate (GFR).

The Extravasation Detection Accessory (EDA™) is an optional accessory and is indicated for the detection of extravasations of ionic and nonionic contrast during CT procedures using a power injector.

Protocols have been independently developed and are not intended as medical advice. Bracco and Bracco Injeneering S.A. shall not be responsible for any physicians’ reliance on these or any other products.

 

CONTRAINDICATIONS:

The EmpowerCTA®+ Injector System is not intended for use as a long-term infusion pump, nor is it intended to be used to inject any agents other than contrast or flushing media. Do not attempt to use the Injector for any other purpose (such as chemotherapy or drug infusion). The EmpowerCTA+ Injector System should not be used to inject substances into nonvascular body cavities. Any applications of the EmpowerCTA+ Injector System other than those described in its Operator Manual are inappropriate and should not be attempted.

Not all products available in all global markets.

EmpowerCTA+ is distributed by Bracco Diagnostics Inc.; 259 Prospect Plains Road, Bldg. H; Monroe Township, NJ 08831 USA; Phone: (800) 631-5245; Fax: (609) 514-2424; Customer Service: 1-877-BRACCO 9 (1-877-272-2269); Professional Services: 1-800-257-5181 (Option 2); EmpowerCTA+ Email: empowerinfo@diag.bracco.com; Website: https://www.braccoimaging.com/us-en/products/injectors-informatics/empowercta

EmpowerCTA+ is manufactured for Bracco Injeneering S.A., Avenue de Sevelin 46, CH – 1004 Lausanne, Switzerland. http://imaging.bracco.com

 

EmpowerMR® Injector System

Caution: Federal law restricts this device to sale by or on the order of a physician.

INDICATIONS:

The EmpowerMR® Injector System is indicated for vascular administration of contrast media and flushing media in conjunction with magnetic resonance imaging (MRI).

Protocols have been independently developed and are not intended as medical advice and Bracco shall not be responsible for any physicians’ reliance on these or any other protocols.

Bracco Injeneering S.A. reserves the right at any time and without notice, to change the specifications and features described herein, or to change the production or adjust the product described.

Not all products available in all global markets.

EmpowerMR is distributed by Bracco Diagnostics Inc.; 259 Prospect Plains Road, Bldg. H; Monroe Township, NJ 08831 USA; Phone: (800) 631-5245; Fax: (609) 514-2424; Customer Service: 1-877-BRACCO 9 (1-877-272-2269); Professional Services: 1-800-257-5181 (Option 2); Website: https://www.braccoimaging.com/us-en/products/injectors-informatics/empowermr

EmpowerMR is manufactured by Bracco Injeneering S.A., Avenue de Sevelin 46, CH – 1004 Lausanne, Switzerland. http://imaging.bracco.com

 

NEXO® Contrast Management System

Intended Use:

The NEXO® Contrast Management System is a server-based application intended to be used as a data-management and visualization system. The NEXO Contrast Management System is able to read, store, share, compare/relate, as well as graphically display data and injection programs coming from RIS, PACS and multiple enabled EmpowerCTA® Injector Systems. This device provides users with record-lists, graphics and reports about data and performances.

This device is intended for retrospective and statistical data management and visualization. It is not intended for real-time data visualization, diagnostic applications or for any other use for which the device is not indicated. This device is only to be operated by and under quasi-continuous supervision of qualified and trained staff in an appropriate licensed healthcare facility.

The NEXO Contrast Management System is compatible with the EmpowerCTA Injector System version 8.0, and EmpowerCTA®+ Injector System version 9.0 and higher.

Bracco Injeneering S.A. reserves the right at any time and without notice, to change the specifications and features described herein, or to change the production or adjust the product described.

Not all products available in all global markets.

NEXO is distributed by Bracco Diagnostics Inc.; 259 Prospect Plains Road, Building H; Monroe Township, NJ 08831 USA; Phone: (800) 631-5245; Fax: (609) 514-2424; NEXO Customer Service: 1-877-BRACCO 9 (1-877-272-2269); NEXO questions: Nexo.Answers@diag.bracco.com; NEXO U.S. Technical Service and Support: Phone: 888-670-7701; Fax: 609-514-2448; NEXO Email:  customer.support@acistmedical.com; Website: https://imaging.bracco.com/us-en/products/injectors-informatics/nexo

NEXO is manufactured by Bracco Injeneering S.A., Avenue de Sévelin 46, CH-1004 Lausanne, Switzerland. http://imaging.bracco.com

 

NEXO [DOSE]® Multi-Modality Radiation Informatics

Intended Use:

NEXO [DOSE]® Multi-Modality Radiation Informatics is a server-based application that acquires, stores, and reports radiation dose index data from medical imaging procedures.

NEXO [DOSE] Multi-Modality Radiation Informatics is intended to be used by qualified medical personnel only.

NEXO [DOSE] is distributed by Bracco Diagnostics Inc.; 259 Prospect Plains Road, Building H; Monroe Township, NJ 08831 USA; Phone: (800) 631-5245; Fax: (609) 514-2424; NEXO [DOSE] Customer Service: 1-877-BRACCO 9 (1-877-272-2269); NEXO [DOSE] questions: Nexo.Answers@diag.bracco.com; Website: https://imaging.bracco.com/us-en/products/injectors-informatics/nexo-dose NEXO [DOSE] Technical Support provided by PACSHealth, L.L.C: 1-877-299-6587

NEXO [DOSE] is manufactured by and is licensed from PHS Technologies Group, L.L.C, 32531 N. Scottsdale Road, Suite #105-282, Scottsdale, AZ 85266; a wholly-owned subsidiary of PACSHealth, L.L.C.

Not all products available in all global markets.

 

About Bracco Injeneering S.A.

Bracco Injeneering S.A., located in Lausanne, Switzerland, is the most recently added Business Unit of Bracco Imaging. Bracco Injeneering is committed to develop the best-in-class integrated injection solutions with a strong heritage in research and innovation. It provides quality solutions for state-of-the-art radiology centers, offering proven injection technology, built on Bracco Imaging’s expertise.

Thanks to this strengthened product portfolio, including the CT Exprès® 3D Contrast Media Delivery System, EmpowerCTA+ Injector System, EmpowerMR Injector System, NEXO Contrast Management System and NEXO [DOSE] Multi-Modality Radiation Informatics, Bracco Imaging will be able to focus on constant innovation, not only for devices, but also for software development and data management.

CT Exprès, EmpowerCTA, EmpowerMR, IRiSCT, NEXO and NEXO [DOSE] are registered trademarks of Bracco Injeneering S.A.

EDA and FastLoad are trademarks of Bracco Injeneering S.A.

These are representative images from reference studies; individual results may vary.

© 2022 Bracco Diagnostics Inc. All Rights Reserved.