Dual-energy CT angiography of abdomen with routine concentration contrast agent in comparison with conventional single-energy CT with high concentration contrast agent

Purpose: To compare the quantitative and subjective image quality in abdominal angiography between dual-energy CT (DECT) at the routine concentration of iodinated contrast agent (300 mg/mL) and conventional 120-kVp single-energy CT (SECT) at the high concentration of contrast agent (370 mg/mL). Materials and methods: Abdominal computed tomography angiography (CTA) was performed in 104 patients, including 56 with conventional 120-kVp SECT at the high concentration of contrast agent and 48 with DECT at the routine concentration of contrast agent. The monochromatic images at the optimal kiloelectron-voltage (key) of DECT that demonstrated the best contrast-to-noise ratio were reconstructed. The signal intensity and noise in abdominal arteries were comparatively analyzed between DECT and SECT. The image quality and visibility of the branch orders of superior mesenteric artery and renal arteries were further assessed. The radiation doses were recorded. Results: Compared with SECT, DECT demonstrated higher signal intensity, signal-to-noise ratio, and contrast-to-noise ratio (all P < 0.01) with moderately increased noise (40%, P < 0.01) in all abdominal arteries. The image quality of DECT was superior to that of SECT (P < 0.01) as evaluated with a subjective five-point scale system. Visualization of the branches of superior mesenteric artery and renal arteries was also better by DECT (P < 0.01) than SECT. The radiation dose of DECT was slight higher than that of SECT (P < 0.0001). Conclusion: DECT with image reconstruction at the optimal keV provides a high-quality angiographic technique, which allows use of a lower concentration of contrast agent compared with conventional 120-kVp SECT. (C) 2014 Elsevier Ireland Ltd. All rights reserved.