Salvage of Suboptimal Enhancement of Pulmonary Artery in Pulmonary CT Angiography Studies: Rapid kVp Switch Dual Energy CT Experience

نویسندگان
doi
10.5812/iranjradiol.97230
چکیده

Background: Multidetector computed tomography (MDCT) angiography is considered as the gold standard imaging modality in the evaluation of acute pulmonary embolism. Optimum vascular enhancement is critical for MDCT studies. The suboptimal opacification in pulmonary artery could be salvaged using low-energy virtual monoenergetic images (VMI) at rapid kVp switch dual energy CT. Objectives: To explore the potential improvement in pulmonary artery opacification and to assess the change in image quality parameters in VMI using fast switch kVp dual energy CT. Results: The mean attenuation of pulmonary arteries was 169.80 HU in standard images in patients with suboptimal enhancement. The attenuations of VMIs at 40, 45, 50, 55, 60, 65, and 70 keV were significantly higher than standard images (P < 0.001). Similar findings were observed with SNR and CNR. In the salvaged patients, the average increase in mean pulmonary artery attenuation was 62% (from 172.61 ± 23.4 to 280.55 ± 40.7), the average increase in SNR was 38% (from 12.1 ± 5.3 to 16.7 ± 7.1) and the average increase in CNR was 48% (9.2 ± 4.3 to 13.7 ± 6) (P < 0.001). Conclusions: Low keV VMI reconstructions significantly increase pulmonary artery attenuation, CNR and SNR compared to standard image reconstructions. Suboptimal CT studies could be salvaged using low keV VMIs.