A Convergence Study on effectiveness of contrast agent reduction by normal saline solution dilution in the computed tomography of arteries of lower limb

하지동맥 전산화단층촬영 검사 시 생리식염수 희석을 통한 조영제 사용량 감소의 융복합 효용성 연구

  • Kim, Sang-Hyun (Dept. of Radiology, Seoul National University Hospital, Dept. of Radiological Science, Eulji University)
  • 김상현 (서울대학교병원 영상의학과, 을지대학교 방사선학과)
  • Received : 2015.07.18
  • Accepted : 2015.09.20
  • Published : 2015.09.28


This convergence study analyzed the effectiveness of contrast agent reduction by normal saline solution dilution in the computed tomography of arteries of lower limb. 48 patients of 125 cc contrast agent and 30 patients of the same amount divided at a ratio of 7:3 for the contrast agent and normal saline solution were studied. The average attenuation coefficient(HU) and signal to noise ratio(SNR) of abdominal aorta, femoral artery, popliteal artery and posterior tibial artery at each image were evaluated quantitatively and the four criteria in the five point scale was conducted qualitatively by two radiologists and four radiological technologists. In the quantitative evaluation, both HU and SNR had high average score before dilation but there were no statistical significance by independent t-test(p>0.05). In the qualitative evaluation, there were a little differences in the average scores between 4.86~4.77 of original contrast agent and 4.83~4.67 of dilated contrast agent but there were no statistical significance(p>0.05). In the computed tomography of arteries of lower limb, the dilated contrast agent doesn't influence image quality and reduces overall contrast agent and lowers iodine content per unit of molecular therefore will contribute to decrease side effect of contrast agent.


Convergence;Arteries of lower limb;Normal saline;Contrast agent;dilution


  1. United Nations Scientific Committee on the Effects of Atomic Radiation(UNSCEAR), 2008 report to the General Assembly annex on medical exposure, New York, 2010.
  2. Y. Park, S. H. Kim, The study of effectiveness of volume mode in pediatric CT, Journal of Digital Convergence, Vol. 12, No. 10, pp. 425-431, 2014.
  3. C. G. Kim, B. S. Park, The evaluation of the radiation dose and the image quality during MDCT using glass rod detector, Journal of Digital Convergence, Vol. 10, No. 2, pp. 249-254, 2012.
  4. M. J. Shin, Y. J. Cho, Management of adverse reaction to iodinated radiocontrast media, J. Korean Med. Association, Vol. 55, No. 8, pp. 779-790, 2012.
  5. J. R. Seon, S. J. Yoo, Studies of the side effects on using the contrast media, J. Korea Saf. Manng. Sci, Vol. 16, No. 4, pp. 427-431, 2014.
  6. M. Kang, N. G. Choi, W. Kim, Y. G. Jang, J. N. Song, Study on optimum contrast media quantity during abdominal CT using dual energy technique, J. Korean. Soc. Radiol, Vol. 9, No. 1, pp. 9-16, 2015.
  7. J. Blacher, R. Asmar, S. Djane, G.M. London, M. E. Safar, Aortic pulse wave velocity as a marker of cardiovascular risk in hypertensive patients, Hypertension, Vol. 33, No. 5, pp. 1111-1117, 1999.
  8. J. W. Shin, S. J. Seok, G. H. Lee, S. C. Choi, K. Y. Hyun, Correlation between arterial stiffness and physiological, parameters, The Korean Journal of Health Service Management, Vol. 7, No. 3, pp. 71-82, 2013.
  9. H. T. An, J. Y. Kim, W. S. Yeo, Y. S. Park, G. W. Lee, J. W. Lee, Research for reducing patient dose that low extremity CT angiography using automatic current selection, Korean J. Digit. Imaging Med, Vol. 15, No. 2, pp. 45-53, 2013.
  10. Graser A, Johnson TR, Bader M, Staehler M, Haseke N, Nikolau K, et al, Dual energy characterization of urinary calculi: initial in vitro and clinical experience, Invest Radiol, Vol. 43, No. 1, pp. 112-119, 2008.
  11. J. H. Lee, S. E, Baek, S. B. Lee, Y. H. Kim, Usefulness of three-dimensional CT image in meningioma using contrast method, The Korean Soc. of Radiology, Vol. 2, No. 1, pp. 17-21, 2008.
  12. S. J. Lee, Y. Park, D. H. Jeong, S. H. Ock, H. J. Hwang, H. S. Hwang, A study on the usefulness of dilution of contrast media in CT examination, Korean Society of Computer Tomographic Technology, Vol. 13, No. 2, pp. 161-167, 2011.
  13. Christiansen C, X-ray contrast media: an overview, Toxicology, Vol. 209, No. 1, pp. 185-187, 2005.
  14. G. J. Jang, D. C. Kwon, M. G. Kim, B. G. Yoo, Development and implementation of a critical pathway for prevention of adverse reactions to contrast media for computed tomography, J. of Radiological Science and Technology, Vol. 30, No. 10, pp. 39-46, 2007.
  15. S. R. Park, S. M. Lee, S. H. Choi, J. Y. Lee, S. U. Lee, Y. H. Jung, S. K. Lee, A case of soyangin double primary cancer patient with adverse reactions induced by contrast media, J. Sasang Constitut Med, Vol. 26, No. 2, pp. 205-212, 2014.
  16. W. S. Yang, S. G. Shin, Consideration of adverse reaction to MDCT contrast media, J. of Radiological Science and Technology, Vol. 35, No. 1, pp. 51-57. 2012.
  17. Katayama H, Yamaguchi K, Kozuka T, Takashima T, Seez P, Matsuura K, Adverse reactions to ionic and nonionic contrast media, A report from the japanese committee on the safely of contrast media, Radiology, Vol. 175, No. 3, pp. 621-628, 1990.
  18. Y. S. Cho, T. N. Chung, D. K. Sohn, S. H. Kim, Contrast nephrotoxicity associated with emergency CT scan, J. Korean Soc. Emerg. Med, Vol. 14, No. 2, pp. 157-161, 2003.
  19. H. H. Kim, J. Y. Choi, M. K. Oh, E. Y. Kim, J. R. Kim, S. J. Choi, J. G. Shin, Retrospective analysis of adverse reactions to iodinated contrast media in korean, The J. of Korean Soc. for Clinical Pharmacology and Therapeutics, Vol. 20, No. 2, pp. 165-174, 2012.
  20. Y. K. Kim, M. S. Kim, S. Y. Lee, J. M. Lee, H. S. Lee, J. S. Jeong, M. G. Kim, Comparison of the contrast effect of the amount and iodine cocentration of CT contrast agent, orean Society of Computer Tomographic Technology, Vol. 16, No. 2, pp. 181-187, 2014.