Hemorrhage 환자에 있어서 Dual-Energy Computed Tomography를 이용한 Head Angiography 검사의 유용성

Usefulness of Head Angiography Examination Using Dual-Energy Computed Tomography for Hemorrhage Patient

Purpose To estimate the availability of dual energy computed tomography(DECT) for the patients who had been underwent head angiography because of bleeding with the image(virtual non-contrast, VNC, 50% mixed image, overlay view) that was obtained by readjusting of iodine concentration at dual-energy processing and volume rendering image. Materials and methods The subjects were 40 patients who had hemorrhage or were suspected to have hemorrhage and took head angiography with DECT in our hospital from April 2009 to January 2010. The method was that we implemented the monitoring scan and set the interest area at aortic arch and made the scanning to be started automatically when Hounsfield unit reached to 100 using by auto bolus triggering. 60 ml of contrast medium was injected at the speed of 4 ml/sec and another 60 ml was injected at the speed of 2.5 ml/sec and 30 ml of saline was added at the speed of 2.5 cc/sec. The estimation was done with computed tomographic angiography(CTA) volume rendering images took from 3D reconstruction process and 2D mapping images(VNC 50% mixed image) took from dual console. Results We had 9 patients of Vascular lesion which was 25.5%, 16 patients of tumor lesion which was 40%, 8 patients of simple hemorrhage which was 20%, 4 patients who didn’t have hemorrhage which was 10%, 2 patients of tauma which was 5%, and 1 patient of hemorrhage caused by uncertain reason which was 2.5%. Conclusion It was concluded that the estimating the reason of hemorrhage using by both volume rendering image in bead angiography by dual energy and 2D mappiing image acquired through dual console can be an useful diagnosis to choose additional examinations and make a decision the direction of the treatment.