Assessment of an advanced virtual monoenergetic reconstruction technique in cerebral and cervical angiography with third-generation dual-source CT: Feasibility of using low-concentration contrast medium

作者：Zhao, Lu; Li, Fengtan; Zhang, Zewei; Zhang, Zhang; Jiang, Yingjian; Wang, Xinyu; Gu, Jun; Li, Dong^*

来源：European Radiology, 2018, 28(10): 4379-4388.

DOI：10.1007/s00330-018-5407-1

• Cerebral arteries
• Carotid arteries
• Computed tomography angiography
• Monoenergetic imaging
• Low-concentration contrast medium

Objectives To investigate the feasibility of low-concentration contrast media (LC-CM) in cerebral and cervical dual-energy CT angiography (DE-CTA) using an advanced monoenergetic (Mono+) reconstruction technique.
Methods Sixty-five consecutive patients prospectively selected to undergo cerebral and cervical DE-CTA were randomised into two groups: 32 patients (63.7 9.7 years) in the high-concentration contrast medium (HC-CM) group with iopromide 370 and 33 patients (60.7 10.8 years) in the low-concentration contrast medium (LC-CM) group with iodixanol 270. Traditional monoenergetic (Mono) and Mono+ images from 40 to 100 keV levels (at 10-keV intervals) and the standard mixed (Mixed, 120 kVp equivalent) images were reconstructed. Subjective image quality parameters included the contrast-to-noise ratio (CNR) and objective image quality parameters were evaluated and compared between the two groups.
Results The 40-keV Mono+ images in the LC-CM group showed comparable objective CNR (common carotid arteries: 83.7 24.5 vs. 78.1 23.2; internal carotid arteries: 82.2 +/- 26.8 vs. 76.8 +/- 24.1; middle cerebral arteries: 72.5 +/- 24.6 vs. 70.6 +/- 19.2; all p > 0.05) and subjective image scores (3.95 +/- 0.19 vs. 3.83 +/- 0.35; p > 0.05) compared with Mixed images in the HC-CM group.
Conclusion The Mono+ reconstruction technique could reduce the concentration of iodinated CM in the diagnosis of cerebral and cervical angiography.
Key Points Mono+ shows decreased noise and superior CNR compared with Mono. The 40-keV Mono+ images show the highest CNR in the LC-CM group. The Mono+ reconstruction technique could reduce the concentration of iodinated CM.

• 出版日期2018-10
• 单位天津医科大学