It has been reported that a reduction in tube kilovoltage during computed tomography (CT) angiography results in an average reduction of the effective radiation dose. Furthermore, a lower kilovoltage has been shown as a technique dose. However, there is no fundamental data in a low-kilovoltage protocol for CT venography. Thus, the purpose of this study was to investigate contrast enhancement, image noise, and radiation exposure with lower kilovoltage on CT images scanned using phantom of lower limbs and clinical CT images. In order to grasp the effective energy in each tube voltage of the equipment used, we determined the half-value layer using aluminum attenuation coefficient. The phantom of the lower was sealed with contrast agent that was adjusted in various CT values. We scanned this phantom at 80 kVp, 100 kVp, and 120 kVp settings, and evaluated the changes in CT value. We also compared CT values, CTDIvol, contrast enhancement, and radiation exposure with 100 kVp and 120 kVp in patients with suspected pulmonary embolism or deep venous thrombosis. We found the CT value increased 30 HU with 100 kVp settings, and contrast was also improved. A reduction of radiation exposure without deterioration of image quality would be possible by lowering the kilovoltage setting in CT venography.

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