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Injection of gadolinium contrast through pediatric central venous catheters: a safety study

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Abstract

Background

Catheter rupture during CT angiography has prompted policies prohibiting the use of electronic injectors with peripherally inserted central venous catheters (PICCs) not only for CT but also for MRI. Consequently, many institutions mandate hand injection for MR angiography, limiting precision of infusion rates and durations of delivery.

Objective

To determine whether electronic injection of gadolinium-based contrast media through a range of small-caliber, single-lumen PICCs would be safe without risk of catheter rupture over the range of clinical protocols and determine whether programmed flow rates and volumes were realized when using PICCs for contrast delivery.

Materials and methods

Experiments were performed and recorded using the Medrad Spectris Solaris EP MR Injection System. PICC sizes, contrast media and flow rates were based on common institutional protocols.

Results

No catheters were damaged during any experiments. Mean difference between programmed and delivered volume was 0.07 ± 0.10 mL for all experiments. Reduced flow rates and prolonged injection durations were observed when the injector’s pressure-limiting algorithm was triggered, only in protocols outside the clinical range.

Conclusion

PICCs commonly used in children can withstand in vitro power injection of gadolinium-based contrast media at protocols significantly above clinical levels.

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Acknowledgments

Research support and contrast medium were provided by Bracco Diagnostics (Princeton, NJ, USA). The catheters and PICCs used for testing were provided by Covidien (Mansfield, MA, USA), AngioDynamics (Latham, NY, USA) and Teleflex Medical (Research Triangle Park, NC, USA). Electronic injection system, logger software and technical support were provided by MedRad (Warrendale, PA, USA).

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Correspondence to John M. Moriarty.

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Moriarty, J.M., Kung, G.L., Ramos, Y. et al. Injection of gadolinium contrast through pediatric central venous catheters: a safety study. Pediatr Radiol 42, 1064–1069 (2012). https://doi.org/10.1007/s00247-012-2397-z

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  • DOI: https://doi.org/10.1007/s00247-012-2397-z

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