Dual-Energy Multidetector-Row Computed Tomography of the Hepatic Arterial System: Optimization of Energy and Material-Specific Reconstruction Techniques.
PURPOSE: To investigate the optimal dual-energy reconstruction technique for the visualization of the hepatic arterial system during dual-energy multidetector computed tomographic (MDCT) angiography of the liver. MATERIALS AND METHODS: Twenty-nine nonconsecutive patients underwent dual-energy MDCT angiography of the liver. Synthesized monochromatic (40, 50, 60, and 80 keV) and iodine density data sets were reconstructed. Aortic attenuation, noise, and contrast-to-noise ratio (CNR) were measured. In addition, volume-rendered images were generated and qualitatively assessed by 2 independent readers, blinded to technique. The impact of body size on the readers' scores was also assessed. RESULTS: Aortic attenuation, noise, and CNR increased progressively with decreasing keV and were significantly higher between 40 and 60 keV (P < 0.001). There was a significant improvement of readers' visualization of arterial anatomy at lower monochromatic energies (P < 0.001). Iodine density images yielded significantly higher CNR compared with all monochromatic data sets (P < 0.001). However, iodine density images were scored nondiagnostic by the 2 readers. CONCLUSIONS: Synthesized monochromatic images between 40 and 60 keV maximize the magnitude of arterial enhancement and improve visualization of hepatic arterial anatomy at dual-energy MDCT angiography of the liver. Larger body sizes may counteract the benefits of using lower monochromatic energies.
Marin, D; Caywood, DT; Mileto, A; Reiner, CS; Seaman, DM; Patel, BN; Boll, DT; Nelson, RC
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