Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Imaging Findings of Peripheral Arterial Disease on Lower-Extremity CT Angiography Using a Virtual Monoenergetic Imaging Algorithm

가상의 단일 에너지 영상 재구성 기법을 이용한 하지 단층촬영 혈관조영술에서 말초 동맥 질환 영상 소견

  • Jun Seong Kim (Department of Radiology, Gil Medical Center, Gachon University College of Medicine) ;
  • So Hyun Park (Department of Radiology, Gil Medical Center, Gachon University College of Medicine) ;
  • Suyoung Park (Department of Radiology, Gil Medical Center, Gachon University College of Medicine) ;
  • Jung Han Hwang (Department of Radiology, Gil Medical Center, Gachon University College of Medicine) ;
  • Jeong Ho Kim (Department of Radiology, Gil Medical Center, Gachon University College of Medicine) ;
  • Seong Yong Pak (Department of Biomedical Engineering, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kihyun Lee (Department of Radiology, Gil Medical Center, Gachon University College of Medicine) ;
  • Bernhard Schmidt (Siemens Healthineers)
  • 김준성 (가천대학교 의과대학 길병원 영상의학과) ;
  • 박소현 (가천대학교 의과대학 길병원 영상의학과) ;
  • 박수영 (가천대학교 의과대학 길병원 영상의학과) ;
  • 황정한 (가천대학교 의과대학 길병원 영상의학과) ;
  • 김정호 (가천대학교 의과대학 길병원 영상의학과) ;
  • 박성용 (울산대학교 의과대학 서울아산병원, 아산융합의학원 의공학과) ;
  • 이기현 (가천대학교 의과대학 길병원 영상의학과) ;
  • Received : 2021.12.09
  • Accepted : 2022.02.28
  • Published : 2022.09.01
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Abstract

Peripheral arterial disease (PAD) is common in elderly patients. Lower-extremity CT angiography (LE-CTA) can be useful for detecting PAD and planning its treatment. PAD can also be accurately evaluated on reconstructed monoenergetic images (MEIs) from low kiloelectron volt (keV) to high keV images using dual-energy CT. Low keV images generally provide higher contrast than high keV images but also feature more severe image noise. The noise-reduced virtual MEI reconstruction algorithm, called the Mono+ technique, was recently introduced to overcome such image noise. Therefore, this pictorial review aimed to present the imaging findings of PAD on LE-CTA and compare low and high keV images with those subjected to the Mono+ technique. We found that, in many cases, the overall and segmental image qualities were better and metal artifacts and venous contamination were decreased in the high keV images.

말초동맥질환은 고령의 환자들에게서 흔하게 발생하며, 하지 동맥 단층촬영 혈관조영술은 말초동맥질환을 발견하고 치료 계획을 세우는데 유용하다. 특히, 이중에너지 단층 촬영을 통해 낮은 kiloelectron volt (이하 KeV) 영상부터 높은 KeV 영상까지 단일 에너지 영상을 재구성하면, 말초동맥질환을 정확하게 평가하는데 도움이 된다. 일반적으로 낮은 KeV 영상은 높은 대조도를 제공해 주지만, 낮은 KeV 영상은 높은 KeV 영상보다 더 심한 잡음을 제공한다는 단점도 있다. 최근에 낮은 KeV 영상에서 잡음을 극복하기 위해 Mono+ 기술이 도입되었다. 따라서, 본 임상 화보에서는 Mono+ 기법으로 시행한 하지동맥 단층촬영 혈관조영술에서의 말초동맥질환의 영상 소견을 보여주며 낮은 KeV 영상과 높은 KeV 영상의 특성이 어떻게 다른지 비교하여 보여주고자 한다. 많은 사례에서, 전체적인 영상의 질과 말초동맥질환을 평가하고자 하는 구간에서의 영상의 질은 모두 높은 KeV에서 더 좋았고, 금속 인공물과 정맥 오염은 높은 KeV 영상에서 감소했다.

Keywords

References

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