Carotid cta: comparison of image quality after left versus right arm injections

Invited Review—computed Tomographic Angiography (Cta) of the Thoracic Cardiovascular System in Companion Animals

“…56,57 The bolus of contrast medium is reportedly ideally injected through the right cephalic vein, which results in fewer artifacts compared to the left vein in humans. 58 It will then move through the afferent cranial vena cava into the right atrium and ventricle, through the main pulmonary artery and its branches, capillary bed, and return through the pulmonary veins to the left atrium and ventricle before entering the systemic circulation in the first pass. Even though a defined bolus is injected, admixture of the contrast medium with the blood in the vascular system will cause dilution that increases after the first pass and flatten the bolus peak further downstream.…”

“…The bolus of contrast medium is reportedly ideally injected through the right cephalic vein, which results in fewer artifacts compared to the left vein in humans . It will then move through the afferent cranial vena cava into the right atrium and ventricle, through the main pulmonary artery and its branches, capillary bed, and return through the pulmonary veins to the left atrium and ventricle before entering the systemic circulation in the first pass.…”

Intracranial Venous Sinus Reflux on CT Angiography: Benign or Malignant Entity?

“…Studies have shown that venous reflux may occur till the level of neck veins (brachiocephalic or internal jugular veins) in CTA. 1 2 3 Common causes for venous reflux are severe heart failure, stenosis in the brachiocephalic vein, absence of valves or valvular insufficiency in IJV, superior vena cava syndrome, and mediastinal masses. 4 5 6 7 If the scan is acquired in expiratory phase, it can also lead to increased venous reflux due to increased positive thoracic pressure during expiration.…”

“…This may lead to incorrect diagnoses like thrombosis and even dissection of adjacent arteries. 1 Studies have shown that venous reflux may occur till the level of neck veins (brachiocephalic or internal jugular veins) in CTA. [1][2][3] Common causes for venous reflux are severe heart failure, stenosis in the brachiocephalic vein, absence of valves or valvular insufficiency in IJV, superior vena cava syndrome, and mediastinal masses.…”

Effect of Right-Sided Versus Left-Sided Contrast Injection on Intra-arterial Opacification Characteristics of Head and Neck Computed Tomography Angiograms and Interactions With Patient Sex, Weight, and Cardiac Output

“…1). [16][17][18][19][20] However, little work has been performed proving that RSI results in improved cervical and intracranial intra-arterial opacification. Only 1 study has examined the effects of left-sided versus right-sided contrast injection on cervical vessel opacification, which demonstrated a nonsignificant trend for higher attenuation values in the carotid arteries with RSIs.…”