Significance of enhanced cerebral gray-white matter contrast at 80 kVp compared to conventional 120 kVp CT scan in the evaluation of acute stroke

J Clin Neurosci. 2014 Sep;21(9):1591-4. doi: 10.1016/j.jocn.2014.03.008. Epub 2014 Apr 24.

Abstract

We aimed to determine whether 80 kVp conventional nonenhanced head CT scans have better gray-white matter contrast than standard 120 kVp scans performed on the same patients. Thirty head CT scans acquired at 80 kVp (CT dose index [CTDI]vol 46) were compared to prior studies in the same patients performed at 120 kVp (CTDIvol 59). Signal (Hounsfield units [HU]), noise (sd HU), and contrast-to-noise ratio per dose (CNRD) were assessed in multiple cerebral gray and white matter regions of interest. A noise correction factor was used to compensate for scanning at different CTDIvol values. Average gray matter signal at 80 kVp and 120 kVP was 33.9 ± 3.5 HU and 29 ± 4.6 HU, respectively (p<0.0001); the averages for white matter were 22.5 ± 3.1 HU and 21.6 ± 4.6 HU, respectively (p=0.11). Corrected noise was 3 ± 0.6 and 2.7 ± 0.6, respectively, for gray matter (p=0.0001), and 2.8 ± 0.6 and 2.6 ± 0.5, respectively, for white matter (p=0.00001). The gray-white matter CNRD was 4.0 ± 1.2 at 80 kVp and 2.8 ± 1 at 120 kVp (p<0.00001). Cerebral gray-white matter CNRD is increased by 40% at 80 kVp compared to conventional 120 kVp CT scans. These findings justify further clinical evaluation in the acute stroke setting.

Keywords: Acute ischemic stroke; Computed tomography; Low dose; Low kVp.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Brain / diagnostic imaging*
  • Carcinoma, Renal Cell / diagnostic imaging
  • Female
  • Gray Matter / diagnostic imaging*
  • Head / diagnostic imaging
  • Humans
  • Male
  • Multiple Myeloma / diagnostic imaging
  • Radiation Dosage
  • Retrospective Studies
  • Stroke / diagnostic imaging*
  • Tomography, X-Ray Computed / methods*
  • White Matter / diagnostic imaging*