Dual Energy Head and Neck CTA
SOMATOM Definition Dual Energy Scanning
Anders Persson, MD, PhD
Center for Medical Image Science and Visualization (CMIV) Hälsouniversitetet/Radiologi - Linköpings Universitet
A 72 year old female patient arrives to CMIV at the University Hospital in Linköping, Sweden. She has been having two episodes of amarosis fugax two times last month and a severe holocephal headache for the last six hours. A CTA of the head and neck were performed at CMIV.
An occlusion of the right internal carotid artery (ICA) and a 95% stenosis of proximal part of the external carotid artery (ECA) 95% is noted. With the DE technique it was possible to visualize the region of the carotid bifurcation with the different plaque components. The ECA stenosis was first overlooked on the conventional single energy CTA images. The direct subtraction of bone without user interaction gives virtual real time display of the whole cerebral vasculature and allows immediate rule out of aneurysms and embolism. Figure 4, same image with and without i.v contrast. The patient was referred for stent angioplasty.
In the dual energy mode two x-ray sources can be operated simultaneously at different kV levels. One of the results is that the plaque composition can be better determined and calcified plaques can be separated from intra luminal contrast.
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