The Application Values Of Advanced Virtual Monoenergetic On 3rd Generation Dual-Source Dual-energy Computed Tomography Angiography In Evaluating Vessels In The Medial And Lateral Circumflex Femoral Artery

ObjectiveTo investigate the value of advanced virtual monoenergetic technique(here after mono-plus)from third-generation dual-energy computed tomography(CT)for improving vessel visualization of medial and lateral circumflex femoral artery CT angiography(CTA).Methods40patients(35~66years,27 male,13 female)underwent 3rd generation dual-energy CT scans(90/Sn150kVp).Mono-plus images(40keV),non-linearly blending images,optimal keV images and Mixed images(M=0.6)were calculated and compared.Both objective and subjective image quality were assessed.Attenuation was measured in the femoral artery(the first arterial branch grade),femoral profound artery(the second arterial branch grade),lateral circumflex femoral artery(the third arterial branch grade),transversal branch of lateral circumflex femoral artery(the fourth arterial branch grade),medial circumflex femoral artery(the third arterial branch grade)and profound branch of medial circumflex femoral artery(the fourth arterial branch grade).Noise was measured in the gluteus maximus.Signal-to-noise(SNR)and contrast-to-noise ratios(CNR)were calculated for each patient and segment.Comparisons between non-linearly blending images,mixed images,optimal keV images and 40 keV mono-plus images were performed by analysis of variance(ANOVA.).Subjective image quality was compared with Kruskal-Wallis test.ResultsIt is shown by quantitative analysis of 40 patients that CT value of four arterial branches grade reached top in mono-plus 40 keV images and was the lowest at Mixed images(P<0.05).Although SNR obtained at mono-plus 40 keV images of four arterial branches grade was lower than non-linear blending images(P<0.05),that of the first and second arterial branches grade was higher as compared to Mixed images(P<0.05),and showed no statistically significant difference from the optimal keV images(P>0.05).The SNR of the third and fourth arterial branches grade in mono-plus 40 keV images showed no statistically significant difference compared to the Mixed images and the optimal keV images(P>0.05).For all dual-energy voltage combinations,based on the favorable basis of SNR in mono-plus 40 keV images,the CNR of the four arterial branches grade at mono-plus 40 keV images was significantly superior to the other data sets(P<0.01),led to superior significant results compared with the other three data sets.ConclusionAdvanced virtual monoenergetic images from 3rd generation dual-source dual-energy CT could provide better visualization for medial and lateral circumflex femoral artery,especially of tiny and distal branches.