• V Leung, A Sastry, T D Woo, and H R Jones.
• Imaging Department, Royal Stoke University Hospital, Newcastle Road, Stoke-on-Trent, ST4 6QG, UK. Electronic address: Vincent.leung@uhns.nhs.uk.
• Clin Radiol. 2015 Oct 1; 70 (10): 1110-5.

AimTo quantify the dose reduction and ensure that the use of a split-bolus protocol provided sufficient vascular enhancement.Materials And MethodsBetween 1 January 2014 and 31 May 2014, both split bolus and traditional two-phase scans were performed on a single CT scanner (SOMATOM Definition AS+, Siemens Healthcare) using a two-pump injector (Medrad Stellant). Both protocols used Siemens' proprietary tube current and tube voltage modulation techniques (CARE dose and CARE kV). The protocols were compared retrospectively to assess the dose-length product (DLP), aortic radiodensity at the level of the coeliac axis and radiodensity of the portal vein.ResultsThere were 151 trauma CT examinations during this period. Seventy-eight used the split-bolus protocol. Seventy-one had traditional two-phase imaging. One patient was excluded as they were under the age of 18 years. The radiodensity measurements for the portal vein were significantly higher (p<0.001) in the split-bolus protocol. The mean aortic enhancement in both protocols exceeded 250 HU, although the traditional two-phase protocol gave greater arterial enhancement (p<0.001) than the split-bolus protocol. The split-bolus protocol had a significantly lower (p<0.001) DLP with 43.5% reduction in the mean DLP compared to the traditional protocol.ConclusionSplit-bolus CT imaging offers significant dose reduction for this relatively young population while retaining both arterial and venous enhancement.Copyright © 2015 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

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