The usefulness of a test bolus of contrast medium for predicting the optimal scan delay time in spiral CT-angiography (CTA) was determined. Two axial single level CT studies were performed at the level of the pancreas in 20 patients, first after injection of a 12 ml "test" bolus, second after administration of a 90 ml bolus. The time interval between the start of the test bolus injection and peak aortic enhancement (T-peak) was measured and compared with the time required to reach a 50, 100, and 150 HU level of aortic enhancement after 90 ml bolus injection. The time required to reach 50, 100, and 150 HU enhancement during the 90 ml bolus was largely variable (mean SD 4.9 s). The T-peak varied between 11 and 32 s (mean 20, SD 6.1 s). There was a strong correlation between the T-peak and the time to the different levels of enhancement during the 90 ml bolus (R2 > or = 0.83). The mean time to 50, 100, and 150 HU enhancement was T-peak -3.3 s (SD 2.5 s), T-peak -1.2 s (SD 2.4 s), and T-peak + 1.3 s (SD 2.4 s). The injection of a test bolus improves the timing of a spiral CTA acquisition.