Contrast MIA

*3 phase abdominal scan*

I scanned a post partum patient [plain, arterial and venous] on Canon Aquilion One and the scans really confused us.

Right wrist 18g cannula; 80ml Visipaque 320 and 25ml saline injected at 3.5m/s.

I scanned the plain first and then injected the contrast. The arterial was scanned at 20s post start of injection (early atrerial) and NO CONTRAST was seen on the scan.

The venous scan commenced at 75s post injection and no contrast was seen again, scan aborted half way.

No extravasation noted [topogram of injection site and arm confirmed this], no leak from the injection site. Patient reported feeling warm and tasted metal [usual effects of contrast injection].

I did a scout of the abdomen 10min post injection and the bladder was full of contrast.

We inserted a new 20g cannula in the left antecubital and this time I monitored the contrast flow using S&V and SureStart. Contrast was seen flowing in the aorta and I was able to acquire arterial and venous phases.

So rhe question is: what the hell happened to the first 80ml of contrast?!

TL;DR - scanned arterial and venous abdomen after successful contrast injection and no contrast seen on acquisitions.

EDIT: to anyone saying weight was a factor abd the contrast was diluted I repeated the exact same scan with the same contrast amount and speed and managed to see the contrast, this time with a new cannula.