Virtual Monoenergetic Imaging and Iodine Perfusion Maps Improve Diagnostic Accuracy of Dual-Energy Computed Tomography Pulmonary Angiography With Suboptimal Contrast Attenuation

被引：65

作者：

Leithner, Doris ^{[1
]}

Wichmann, Julian L. ^{[1
]}

Vogl, Thomas J. ^{[1
]}

Trommer, Jesko ^{[1
]}

Martin, Simon S. ^{[1
]}

Scholtz, Jan-Erik ^{[1
]}

Bodelle, Boris ^{[1
]}

De Cecco, Carlo N. ^{[2
]}

Duguay, Taylor ^{[2
]}

Nance, John W., Jr. ^{[2
]}

Schoepf, U. Joseph ^{[2
]}

Albrecht, Moritz H. ^{[1
,2
]}

机构：

[1] Univ Hosp Frankfurt, Dept Diagnost & Intervent Radiol, Theodor Stern Kai 7, D-60590 Frankfurt, Germany

[2] Med Univ South Carolina, Div Cardiovasc Imaging, Dept Radiol & Radiol Sci, Charleston, SC USA

来源：

INVESTIGATIVE RADIOLOGY | 2017年 / 52卷 / 11期

关键词：

dual-energy CT; computed tomography pulmonary angiography; pulmonary embolism; virtual monoenergetic imaging; diagnostic accuracy; suboptimal contrast attenuation; CT ANGIOGRAPHY; LUNG PERFUSION; KEV-SETTINGS; EMBOLISM; RECONSTRUCTION; QUALITY; INSPIRATION; IMPACT; IMAGES; OPTIMIZATION;

D O I：

10.1097/RLI.0000000000000387

中图分类号：

R8 [特种医学]; R445 [影像诊断学];

学科分类号：

1002 ; 100207 ; 1009 ;

摘要：

Objectives: The aim of this study was to investigate the impact of virtual monoenergetic imaging (VMI+) and dual-energy computed tomography perfusion maps (DECT-PMs) on reader confidence and diagnostic accuracy in dual-energy computed tomography pulmonary angiography (DE-CTPA) studies with suboptimal contrast attenuation, compared with standard linearly blended reconstruction series. Materials and Methods: Dual-energy computed tomography pulmonary angiography examinations with suboptimal contrast attenuation of 68 patients with suspected pulmonary embolism (PE) were included in this institutional review board-approved retrospective study. Virtual monoenergetic imaging series at 40 keV, DECT-PM, and linearly blended images (M_0.6, 60% 90-kV spectrum) were reconstructed. Contrast-to-noise ratio and signal-to-noise ratio within the pulmonary trunk were calculated. Four independent radiologists assessed the presence of PE and their diagnostic confidence using 3 DE-CTPA reconstruction protocols: protocol 1, M_0.6 images; protocol 2, M_0.6 series and DECT-PM; and protocol 3, M_0.6, DECT-PM, and VMI+ series. Receiver operating characteristic (ROC) analysis was performed. Results: Fourteen patients showed central and 29 segmental PE. Greater contrastto-noise ratio and signal-to-noise ratio values were measured in VMI+ series at 40 keVin comparison to M_0.6 images (P < 0.001). Diagnostic accuracy for segmental PE detection was as follows: protocol 1 (69.1%); protocol 2 (86.8%); and protocol 3 (92.6%). Protocol 3 resulted in a significantly greater area under the curve for diagnosing segmental PE (0.991, P <= 0.033), compared with protocol 1 and 2 (0.897 and 0.951, respectively), and provided the highest diagnostic confidence (P < 0.001). Conclusions: A reconstruction protocol including 40-keV VMI+ series and DECT-PM improves reader confidence and diagnostic accuracy for segmental PE detection compared with standard M_0.6 images in DE-CTPAwith suboptimal contrast attenuation.

引用

页码：659 / 665

页数：7

共 41 条

[1] Comprehensive Comparison of Virtual Monoenergetic and Linearly Blended Reconstruction Techniques in Third-Generation Dual-Source Dual-Energy Computed Tomography Angiography of the Thorax and Abdomen [J].