Dual-source dual-energy CT angiography with virtual non-enhanced images and iodine map for active gastrointestinal bleeding: Image quality, radiation dose and diagnostic performance

Sun, Hansong; Hou, Xinyi; Xue, Huadan; Li, Xiaoguang; Jin, Zhengyu; Qian, Jiaming; Yu, Jiang; Zhu, Huadong

doi:10.1016/j.ejrad.2015.01.013

Cited by 64 publications

(34 citation statements)

References 27 publications

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“…These can be used to visualize the increased attenuation of bone marrow edema and combined into a mixed image similar to that of traditional single-energy CT. DE CT is thus commonly performed by using radiation doses equivalent to or even lower than those for single-energy CT (21). In addition, because VNC images can be created retrospectively from postcontrast DE CT scans, DE CT can substantially reduce the radiation dose in certain cases by eliminating the need for an unenhanced CT acquisition (22)(23)(24)(25).…”

Section: Radiation Dose With De Ctmentioning

confidence: 99%

Dual-Energy CT for Abdominal and Pelvic Trauma

et al. 2018

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Computed tomography (CT) is key to the assessment of hemodynamically stable patients with blunt or penetrating trauma to the abdomen and pelvis. Dual-energy (DE) CT is a technology that allows acquisition of data at both high and low kilovolt peaks, allowing materials that have different x-ray absorption behaviors as a function of kilovolt peak (such as iodine) to be differentiated and quantified. DE CT has a variety of postprocessing applications that may be helpful in abdominal and pelvic trauma, including iodine-selective imaging, virtual monenergetic imaging, and virtual noncalcium imaging. Both iodine-selective imaging and virtual monoenergetic imaging can increase the conspicuity of traumatic solid-organ and hollow visceral injuries, making injuries easier to detect and categorize. Iodine-selective imaging, through the use of iodine maps and virtual noncontrast images, can assist in the evaluation of active contrast extravasation. Virtual noncalcium images can unmask bone marrow edema, improving detection of subtle fractures. The purpose of this review article is to familiarize radiologists with the basic physics and technical principles of DE CT, common postprocessing techniques, and the potential added value of DE CT in patients with abdominal and pelvic trauma. The technical limitations of DE CT are also reviewed, as are diagnostic pitfalls and common challenges in interpretation. RSNA, 2018.

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Section: Radiation Dose With De Ctmentioning

confidence: 99%

Dual-Energy CT for Abdominal and Pelvic Trauma

et al. 2018

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“…Wells et al (1) thoroughly describe the protocols used to perform three-phase monoenergetic CT angiography and two-phase dual-energy CT angiography, and they discuss the potential advantages of acquiring virtual noncontrast and simulated monochromatic images and iodine maps. However, as they also note, the investigators in one study (11) did not discern a significant difference in diagnostic yield between the three-phase and two-phase techniques. In addition, the availability of two-phase dualenergy CT angiography may be limited, whereas three-phase CT angiography is widely available.…”

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confidence: 88%

Invited Commentary on “CT for Evaluation of Acute Gastrointestinal Bleeding”

Morris

2018

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“…A meta-analysis of data from 672 patients with moderate to severe UGIB and/or LGIB revealed an overall sensitivity of 85% and a specificity of 92% for detection of the bleeding site. The detection rates with CT angiography increase when patients have evidence of severe bleeding or hemodynamic instability (33,37,(45)(46)(47)(48). For example, in a study involving 113 consecutive patients (45), the cause of the bleeding was found in 70.5% of patients who had severe bleeding-defined by a systolic blood pressure lower than 100 mm Hg, heart rate greater than 100 beats per minute, hemoglobin level lower than 100 g/L, and/or more than four units of RBCs transfused within 24 hours-versus in 64.1% of those who did not meet the criteria for severe bleeding (45).…”

Section: Ct Evaluation Of Acute Gi Bleedingmentioning

confidence: 99%

CT for Evaluation of Acute Gastrointestinal Bleeding

et al. 2018

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Acute gastrointestinal (GI) bleeding is common and necessitates rapid diagnosis and treatment. Bleeding can occur anywhere throughout the GI tract and may be caused by many types of disease. The variety of enteric diseases that cause bleeding and the tendency for bleeding to be intermittent may make it difficult to render a diagnosis. The workup of GI bleeding is frequently prolonged and expensive, with examinations commonly needing to be repeated. The use of computed tomography (CT) for evaluation of acute GI bleeding is gaining popularity because it can be used to rapidly diagnose active bleeding and nonbleeding bowel disease. The CT examinations used to evaluate acute GI bleeding include CT angiography and multiphase CT enterography. Understanding the clinical evaluation of acute GI bleeding, including the advantages and limitations of endoscopic evaluation, is necessary for the appropriate selection of patients who may benefit from CT. Multiphase CT enterography is used primarily to evaluate stable patients who have undergone upper and lower endoscopy without identification of a bleeding source. CT angiography is used to examine stable and unstable patients who respond to resuscitation, are believed to be actively bleeding, and are considered unlikely to have an upper GI source of hemorrhage. In the emergent setting, CT may yield critical information regarding the presence, location, and cause of active bleeding-data that can guide the choice of subsequent therapy. Recent developments in the use of and techniques for performing CT angiography have made it a potential first-line tool for evaluating acute GI bleeding. RSNA, 2018.

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Dual-source dual-energy CT angiography with virtual non-enhanced images and iodine map for active gastrointestinal bleeding: Image quality, radiation dose and diagnostic performance

Cited by 64 publications

References 27 publications

Dual-Energy CT for Abdominal and Pelvic Trauma

Dual-Energy CT for Abdominal and Pelvic Trauma

Invited Commentary on “CT for Evaluation of Acute Gastrointestinal Bleeding”

CT for Evaluation of Acute Gastrointestinal Bleeding

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