Hand Injector System for Gadolinium Contrast Infusion for MRA

When injecting gadolinium contrast dynamically for MR angiography innumerable problems are encountered. Tubing connections can came apart causing gadolinium to spray everywhere. Blood can back out of the IV site if it becomes disconnected from the pressure of the injection. Dead space within the IV tubing can vary depending upon exactly how the IV is set-up. Without knowing the dead space exactly it is impossible to know exactly when the gadolinium reaches the end of the IV tubing and begins entering the patient. This increases the unpredictability of bolus timing. Perhaps the greatest problem is switching from gadolinium contrast infusion to saline flush. Any delay in beginning the saline flush creates a gap in the bolus. If this gap coincides with acquisition of central k-space data then it can create ringing artifacts that could be misinterpreted as aortic dissection. When using a 3-way stopcock, the rush to switch from gadolinium infusion to saline flush inevitably occurs a little early so that not all of the gadolinium is injected. The waste of gadolinium can be typically 2-3 ml, which amounts to nearly $10. In addition the image quality is not as good.

Power Injectors are extremely useful in CT and conventional X-ray angiography because technologists and radiologists do not have to be in the room during X-irradiation of the patient. It adds an element of complexity to the injection process for the benefit of reducing radiation exposure to personnel. But in MRI, just like with ultrasound, there is no risk from being in the room during scanning. The relatively smaller volume of dynamic gadolinium contrast injections is easier to manage by hand rather than power injection. Actually it has been shown that injectors are not necessary, and in many ways they are not as good as injecting by hand, since injecting by hand makes it easier to identify problems with the IV.

Unfortunately none of the intravenous tubing normally available is well suited for the purpose of dynamic gadolinium injections for MRA or MRI. SmartSet is a refined design of an IV tubing system. Design development has involved tubing lumen, resistance, wall thickness, type of connectors, adaptability to different required lengths, one-handed operation, a valve assembly for automatic switching between gadolinium contrast infusion and saline flush. SmartSet has been used for thousands of cases of dynamic gadolinium contrast infusions for MR Angiography, liver MRI, breast MRI and other dynamic contrast injection with universally favorable experiences, and is now available to perform dynamic MR contrast injections by hand.