Objectives To investigate the accuracy of dual-energy (DE) CT-based iodine maps (IM) and noise-optimised monoenergetic extrapolations (MEI+) at 40 keV for the detection and differentiation of venous thrombosis (VT) from iodine flux artefacts (IFA) in comparison to portal-venous phase CT (CT ). PV Methods Ninety-nine patients were enrolled in this study. In all patients, VT or IFA was suspected on contrast-enhanced CT and confirmed by follow-up CT or colour-coded ultrasound. All examinations were performed on a third-generation dual-source CT system in DE mode during portal-venous phase. CT , IM and 40-keV MEI+ were reconstructed and PV independently evaluated by two radiologists for the presence/absence of VT and/or IFA. Diagnostic confidence was rated on a three-point scale (3 = high confidence). Quantitative parameters were obtained by calculating contrast-to-noise ratios (CNRs), iodine content and thrombus volume. Diagnostic accuracy was assessed by calculating receiver operating characteristics (ROC) of CNR. Results Diagnostic confidence was significantly higher for IM and MEI+ [both 3 (2-3)] compared to CT [2 (1-3); p ≤ 0.03]. PV ROC analysis revealed significantly higher AUC values and increased sensitivity for IM and MEI+ (AUC = 88%/sensitivity = 79.1% and 86%/73.1%) than for CT (75%/61.2%; p ≤ 0.01). Thrombus volume was
European Radiology – Springer Journals
Published: Jun 4, 2018
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