Four groups of 30 patients each, with a body weight of less than 100 kg and receiving pulmonary CTA were matched by age (range, 21-87 years), gender (female/male, 48/72), weight (range, 41-99 kg), and cross sectional area of the chest (range, 468-885 cm(2)). Seven patients had an increase in serum creatinine level of 88.4 μ mol/L or more in the iopromide group. e diagnosis of PE and its severity w, In a second phase, aer non-inferiority o, main objective of this second study phase was to evalua, phase was to evaluate the diagnostic accuracy of the low CM DE CTP, clinical routine. The attenuation of the pulmonary trunk measured in Hounsfield units (HU) between the equivalent axial slices of the LB120 data set and the VMI+40 data set underwent statistical analysis via a Wilcoxon paired-sample test. Method: Virtual monoenergetic imaging (VMI) and multi-material decomposition (MMD) imaging (see Chap. Pulmonary embolism is the third most common acute cardiovascular disease, after myocardial infarction and stroke, and results in an estimated 200,000-300,000 hospitalizations and 37,000-44,000 deaths per year in the United States [].In 1980, Godwin et al. Access scientific knowledge from anywhere. Conclusion: Three groups with 40 consecutive patients each underwent either standard single-source 100 kVp (120 mAs; group A), single-source 70 kVp (208 mAs; group B), or dual-source 70 kVp CTPA (416 mAs; group C). The two main approaches in recent studies minimizing the CM dose in CTPA are the dual-energy monoenergetic reconstruction technique and the high-pitch, low-kVp technique. Results: Images were acquired with a 3rd generation DE-CT system in DE mode (100/Sn150 kV) and activated tube current modulation 90 s after contrast agent administration. For reduction of beam-hardening artifacts, VM imaging at 120 keV is useful for the initial assessment. Methods: 84 patients underwent clinically indicated thoracoabdominal CTA between February 2011 and May 2012 using high-pitch technique for arterial phase and an individually tailored contrast-media protocol depending on weight-class and scan duration. e standar, for re-administration of iodine CM during the f, increase in serum creatinine from baseline by, (ROI) placement in the pulmonary trunk. No pulmonary embolism was missed on the optimized CM protocol. tomographic (CT) pulmonary angiography has been evaluated with meta-analysis and has dem-onstrated sensitivities of 53%–100% and speci-ficities of 83%–100% (6), wide ranges that are explained in part by technologic improvements over time. VMI+40 (1161.500 HU) yielded a statistically significant increase in median attenuation within the pulmonary trunk compared to the LB120 (304.400 HU), with a median difference between monoenergetic reconstruction and standard dual energy of data sets of 827.5 HU (P < .001). The median number of examinations visually scored concerning pulmonary embolism as good–excellent was 47/47 (range 44–47); adequate 0/47 (0–3) and non-diagnostic 0/47 (range 0–0). CT pulmonary angiography and triple rule-out scanning protocols All patients were scanned on a second generation of dual-source CT scanner (Siemens Definition Flash, Siemens Healthcare, Forchheim, Germany). After checking “matches,” the director of the transplant including merchantability or fitness for any particular purpose. The effective dose for group A was lower by 80% compared to group B (P < 0.001). DE CTPA utilizing image reconstruction at 40/50 keV allowed for a reduction of 84% in iodine load while maintaining CNR, which is especially important in patients with acute/chronic renal failure. RESULTS:Ten weeks after model construction, the bodyweight of rats in the model group was significantly lower than that in the sham-operated group. Although patients who developed AKI acute kidney injury had higher rates of dialysis and mortality, contrast material exposure was not an independent risk factor for either outcome for dialysis ( OR odds ratio , 0.89; 95% CI confidence interval : 0.40, 2.01; P = .78) or for mortality ( HR hazard ratio , 1.03; 95% CI confidence interval : 0.82, 1.32; P = .63), even among patients with compromised renal function or predisposing comorbidities. A preview of this full-text is provided by Springer Nature. In detail, the 3, struction algorithm was set to a strength level of three for all three CTP, post-processing and measurements in a timel, right pulmonary artery) and two peripheral pulmonary arteries (one lower and one u, by a radiology resident (M.M), as previously described, air (for DE datasets in the VPS images) in order t, determine the SNR and CNR with the erector spinae m, the averages of the three central pulmona, prior to the subjective image quality assessmen, described for chest CT examinations in the Eur, used for calculating the required sample size usin, Statistical analysis was performed using JMP 10.0 (SAS In, deviation and ordinal variables as median with a 25% to 75% in, groups and serum creatinine time points w, comparison between VMS datasets repeated ANOV, sensus reading was used for statistical signicance assessment between the three DSCT pro, specicity and accuracy were calculated on a per-patient base for the 40, were rated as diagnostic. 62-year-old woman with suspected pulmonary embolism. This study aims to prove that the test bolus technique provides a better selective imaging study of the pulmonary arterial system in comparison to the automatic bolus-tracking technique. Premium PDF Package. Results were validated with a bootstrapped sensitivity analysis. Results for 1.5 cm slices are statistically evaluated on per slice, per vessel segment ascending aortic, aortic arch, descending and abdominal aorta, right and left iliacal artery (common and external) and per patient level, regarding left-ventricular function and renal impairment. Conclusion: To view a copy of this license, visit. As media representatives gather in Subjective image quality was evaluated using a five-grade scale, and diagnostic accuracy was assessed. Results: In mean 53.1 ± 7.4 ml contrast-medium is administered for aortoiliacal examination. The historically inflated risk of CIN reflects logistic and intellectual pitfalls that continue to confound the study of this disease. educed iodine load at CT pulmonary angiography with dual-energy monochro, . In a next step, the lower spatial frequency stack at low keV is combined with the high spatial frequency stack at optimal keV from a noise perspective to combine the benefits of both images stacks. It was clear that the Main PA average density was 260.5 HU in group A and increased to 320 HU in group B with P value < 0.002. The VMS image at 50 keV displays superior subjective image quality when compared to VPS image. 14,15. e images or other third party material in this, article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the, material. In daily clinical routine, computed tomography (CT) has practically become the first-line modality for imaging of pulmonary circulation in patients suspected of having pulmonary embolism (PE). However, limitations regarding accurate diagnosis of small peripheral emboli have so far prevented unanimous acceptance of CT as the reference standard for imaging of PE. However, computed tomography pulmonary angiography was the dominant modality of diagnosis, even in pregnancy and severe renal insufficiency. Improved contrast attenuation with VM imaging at lower kiloelectron volt levels enables better delineation and diagnostic accuracy in the detection of various vascular or oncologic abnormalities. In this chapter we review clinically established applications of DECT for the main body regions from head to toe. METHODS:Twenty-two male Sprague-Dawley (SD) rats were included as experimental subjects. 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