Virtual monoenergetic dual-energy CT for evaluation of hepatic and splenic lacerations

Purpose To evaluate the utility of virtual monoenergetic imaging in assessing hepatic and splenic lacerations and to determine the optimal energy level to maximize injury contrast-to-noise ratio. Methods We retrospectively examined 49 contrast-enhanced abdominal CT studies performed on a dual-source...

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Bibliographic Details
Published in:Emergency radiology 2019-08, Vol.26 (4), p.419-425
Main Authors: Sun, Ellen X., Wortman, Jeremy R., Uyeda, Jennifer W., Lacson, Roger, Sodickson, Aaron D.
Format: Article
Language:English
Subjects:
Adult
Attenuation
Background noise
Computed tomography
Contrast Media
Emergency Medicine
Energy
Female
Humans
Image acquisition
Image contrast
Imaging
Injuries
Iohexol
Iopamidol
Lacerations - diagnostic imaging
Liver
Liver - injuries
Male
Medical imaging
Medicine
Medicine & Public Health
Noise
Original Article
Patients
Radiographic Image Interpretation, Computer-Assisted
Radiography, Dual-Energy Scanned Projection - methods
Radiology
Retrospective Studies
Spleen
Spleen - injuries
Tomography, X-Ray Computed - methods
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Summary:Purpose To evaluate the utility of virtual monoenergetic imaging in assessing hepatic and splenic lacerations and to determine the optimal energy level to maximize injury contrast-to-noise ratio. Methods We retrospectively examined 49 contrast-enhanced abdominal CT studies performed on a dual-source dual-energy CT (DECT) scanner with reported liver and/or splenic lacerations. All studies included portal venous phase imaging acquired simultaneously at low (80 or 100 kVp) and high (140 kVp with tin filtration) energy levels. Conventional 120 kVp-equivalent images were generated for routine review by blending the low and high energy acquisitions. Virtual monoenergetic reconstructions were retrospectively generated in 10 keV increments from 40 to 90 keV. Liver or splenic laceration attenuation, background parenchymal attenuation, and noise were measured on each set of monoenergetic and conventional images. Injury-to-parenchyma contrast and contrast-to-noise ratios (CNR) were calculated. Differences between CNR of monoenergetic series and conventional images were assessed with a paired t test. Results Liver laceration was identified in 28 patients, and splenic laceration in 22 patients. Background noise was lower at higher monoenergetic levels, with the lowest noise seen at 90 keV, less than that of conventional images (stddev 8.0 for 90 keV and 8.5 for conventional based on noise of uninjured liver/spleen parenchyma, p  
ISSN:1070-3004
1438-1435
DOI:10.1007/s10140-019-01687-y