{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T10:45:53Z","timestamp":1772102753920,"version":"3.50.1"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"1156","license":[{"start":{"date-parts":[[2024,2,21]],"date-time":"2024-02-21T00:00:00Z","timestamp":1708473600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Science Development Foundation of the First Affiliated Hospital of Xi\u2019an Jiaotong University"},{"name":"Key R & D Plan Project of Shaanxi Province\u2014Joint University","award":["2020GXLH-Y-026"],"award-info":[{"award-number":["2020GXLH-Y-026"]}]},{"name":"Key R & D Plan Project of Shaanxi Province\u2014Joint University","award":["2023-YBSF-068"],"award-info":[{"award-number":["2023-YBSF-068"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,3,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To evaluate the clinical value of using a split-bolus contrast injection protocol in improving image quality consistency and diagnostic accuracy in lower extremity CT angiography (CTA).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Fifty (mean age, 66\u2009\u00b1\u200912\u2009years) and 39 (mean age, 66\u2009\u00b1\u200911\u2009years) patients underwent CTA in the lower extremity arteries using split-bolus and fixed-bolus injection schemes, respectively. The objective and subjective image quality of the 2 groups were compared and the diagnostic efficacy for the degree of vessel stenosis was compared using digital subtraction angiography as the gold standard. A P\u2009&amp;lt;\u2009.05 was considered statistically significant.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In comparison with the fixed-bolus scheme, the split-bolus scheme greatly improved the consistency of image quality of the low extremities by significantly increasing the arterial enhancement (337.87\u2009\u00b1\u200964.67HU vs. 254.74\u2009\u00b1\u200971.58HU, P\u2009&amp;lt;\u2009.001), signal-to-noise ratio (22.58\u2009\u00b1\u200911.64 vs. 7.14\u2009\u00b1\u20091.98, P\u2009&amp;lt;\u2009.001), and contrast-to-noise ratio (37.21\u2009\u00b1\u200910.46 vs. 31.10\u2009\u00b1\u200915.40, P\u2009=\u2009.041) in the infrapopliteal segment. The subjective image quality was better (P\u2009&amp;lt;\u2009.001) and the diagnostic accuracy was higher in the split-bolus group than in the fixed-bolus group (96.00% vs. 91.67%, P\u2009&amp;lt;\u2009.05, for diagnosing &amp;gt;50% stenosis, and 97.00% vs. 89.10%, P\u2009&amp;lt;\u2009.05, for diagnosing occlusion) for the infrapopliteal segment arteries.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Compared with the fixed-bolus injection scheme, the split-bolus injection scheme improves the image quality consistency and diagnostic accuracy especially for the infrapopliteal segment arteries in lower extremity CTA.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Advances in knowledge<\/jats:title>\n                  <jats:p>(1) The split-bolus injection scheme of CTA of the lower extremity arteries improves the overall image quality, uniformity of contrast enhancement. (2) Compared with the fixed-bolus injection scheme, the split-bolus injection scheme especially improves the infrapopliteal segment arteries image quality and diagnostic efficacy.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/bjr\/tqae036","type":"journal-article","created":{"date-parts":[[2024,2,21]],"date-time":"2024-02-21T07:52:43Z","timestamp":1708501963000},"page":"838-843","source":"Crossref","is-referenced-by-count":2,"title":["Improving image quality consistency and diagnostic accuracy in lower extremity CT angiography using a split-bolus contrast injection protocol"],"prefix":"10.1093","volume":"97","author":[{"given":"Qian","family":"Tian","sequence":"first","affiliation":[{"name":"Department of Radiology, The First Affiliated Hospital of Xi\u2019an Jiaotong University , Xi\u2019an 710061, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shumeng","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Radiology, The First 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