Objective:

To evaluate the image quality of contrast-enhanced computed tomography (CECT) images obtained with high-flow contrast media injection via high-pressure central venous catheters (HP CVC) compared to standard flow rates through standard CVC, highlighting the clinical significance of this comparison.

Key Findings:

• 75 patients were included: 56 with standard CVC and 19 with HP CVC, indicating a significant sample size for analysis.
• Flow rate was significantly higher in the HP CVC group (median 7.7 mL/s) compared to the standard CVC group (3.5 mL/s, p < 0.001), suggesting potential for improved contrast delivery.
• No significant differences in aortic and liver SNR and CNR measurements between the two groups, indicating that higher flow did not translate to better image quality.

Interpretation:

The use of HP CVC allowed for high-flow injection of contrast media without adverse events, but did not improve objective image quality in CECT, suggesting that other factors may influence image quality.

Limitations:

• The theoretical flow rate of 10 mL/s was not achieved; median flow rate was 7.7 mL/s, which may limit the generalizability of the findings.
• Exact flow rates in the standard CVC group were estimated and not directly measured, introducing potential bias.
• Timing of image acquisition relative to CM injection was unchanged, which may affect results and should be considered in future studies.

Conclusion:

High-flow CM injection via HP CVC does not enhance objective image quality in CECT for critically ill patients. Further studies are warranted in specific populations with altered cardiac output to explore potential benefits.