Spectral CT demonstration of the superior mesenteric artery: comparison of monochromatic and polychromatic imaging

Abstract

Rationale and objectives: To investigate the performance of spectral computed tomography (CT) in depiction of the superior mesenteric artery (SMA) compared to conventional polychromatic CT.

Materials and methods: This prospective study had institutional review board approval, and written informed consent was obtained. Fifty patients underwent spectral CT examination using gemstone spectral imaging with a single-tube, fast dual-tube voltage-switching technique. Spectrum analysis was used to select the monochromatic images that provide the optimal contrast-to-noise ratio (CNR) for SMA angiography. The CNR for SMA at the selected monochromatic level was compared with that from the conventional polychromatic images. Image quality and visibility of the branch order of SMA were also assessed and compared.

Results: The monochromatic images at 50 keV (mean 50.09 ± 1.98) provided the optimal CNR for SMA angiography. At this energy level, the monochromatic images had higher (20.8 vs 9.2) CNR than the polychromatic images, and the image quality was superior to conventional polychromatic images (P < .05). Fourth to fifth (mean 4.3) and third to fourth (mean 3.5) order branches of SMA were demonstrated at monochromatic and polychromatic images, respectively.

Conclusions: Gemstone spectral imaging with monochromatic images at 50 keV by spectral CT could improve the CTA image quality and demonstrate more branch order in depiction of normal SMA compared to conventional polychromatic imaging.

Keywords: CT angiography; Superior mesenteric artery; monochromatic imaging; spectral CT.