Dual Source CT Esophageal varices – Dual Energy imaging for treatment planning

SOMATOM Definition Dual Energy scanning

Author: Satoru Kitano MD, Toshiaki Taoka PhD MD, Kimihiko Kichikawa PhD MD
Nara Medical University, Department of Radiology, Nara / Japan

Date: Jan 28, 2008

History

A 72 year-old male with liver cirrhosis and oesophageal varices was referred to a Dual Source CT scan for planning the endoscopic treatment of his esophageal varices. A scan of the abdomen was performed on the SOMATOM Definition using spiral Dual Energy evaluation.

 

Diagnosis
The patient had developed esophageal varices as a result of portal hypertension secondary to liver cirrhosis. The Dual Energy arterial and portal venous phase scans revealed that collateral blood flow was established over the coronary vein (left gastric vein) to the esophageal varices.

 

Comments
In the Dual Energy scan mode, two x-ray sources can be operated simultaneously at different kV levels. The results are two spiral data sets acquired in a single scan providing diverse information that allows one to differentiate, characterize, isolate, and distinguish the imaged tissue and material. With the Liver Virtual Non-Contrast application, images of the vascular map can be superimposed on MPR virtual non-contrast liver images. In the present case, these images provide valuable information about the venous collateral circulation associated with esophageal varices and therefore make Dual Energy imaging useful for planning the endoscopic treatment of esophageal varices.
 
 

Dual Energy Virtual Non Contrast application visualizes the veins and varices surrounding the esophagus shown in red color. Collateral blood flow was established over the coronary vein.


 

Examination Protocol

 

Scanner
SOMATOM Definition
Scan area
Abdomen
Scan length 237 mm
Scan time 8 s
Scan direction Cranio-caudal
kV
140/80 kV
Effective mAs 50/198 eff mAs
Rotation time
0.5 s
Slice collimation
0.6 mm
Reconstructed slice thickness
1.0 mm
Increment 1.0 mm
Pitch
0.7
Kernel D30f
Contrast amount 100 ml
Contrast flow rate 3 ml/sec

 

 

The information presented is for illustration only and is not intended to be relied upon by the reader for instruction as to the practice of medicine. Any health care practitioner reading this information is reminded that they must use their own learning, training and expertise in dealing with their individual patients. This material does not substitute for that duty and is not intended by Siemens Healthcare to be used for any purpose in that regard.

The drugs and doses mentioned herein are consistent with the approval labelling for uses and/or indications of the drug. The treating physician bears the sole responsibility for the diagnosis and treatment of patients, including drugs and doses prescribed in connection with such use. The Operating Instructions must always be strictly followed when operating the system. The source for the technical data is the corresponding data sheets. Results may vary.

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