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Computed Tomographic Venography for Varicose Veins of the Lower Extremities: Prospective Comparison of 80-kVp and Conventional 120-kVp Protocols

Cho, Eun-Suk MD; Kim, Joo Hee MD; Kim, Sungjun MD; Yu, Jeong-Sik MD; Chung, Jae-Joon MD; Yoon, Choon-Sik MD; Lee, Hyeon-Kyeong MD; Lee, Kyung Hee MD

Journal of Computer Assisted Tomography: September/October 2012 - Volume 36 - Issue 5 - p 583–590
doi: 10.1097/RCT.0b013e3182621ea9
Vascular Imaging

Objective To prospectively investigate the feasibility of an 80–kilovolt (peak) (kVp) protocol in computed tomographic venography for varicose veins of the lower extremities by comparison with conventional 120-kVp protocol.

Methods Attenuation values and signal-to-noise ratio of iodine contrast medium (CM) were determined in a water phantom for 2 tube voltages (80 kVp and 120 kVp). Among 100 patients, 50 patients were scanned with 120 kVp and 150 effective milliampere second (mAseff), and the other 50 patients were scanned with 80 kVp and 390 mAseff after the administration of 1.7-mL/kg CM (370 mg of iodine per milliliter). The 2 groups were compared for venous attenuation, contrast-to-noise ratio, and subjective degree of venous enhancement, image noise, and overall diagnostic image quality.

Results In the phantom, the attenuation value and signal-to-noise ratio value for iodine CM at 80 kVp were 63.8% and 33.0% higher, respectively, than those obtained at 120 kVp. The mean attenuation of the measured veins of the lower extremities was 148.3 Hounsfield units (HU) for the 80-kVp protocol and 94.8 HU for the 120-kVp protocol. Contrast-to-noise ratio was also significantly higher with the 80-kVp protocol. The overall diagnostic image quality of the 3-dimensional volume-rendered images was good with both protocols. The subjective score for venous enhancement was higher at the 80-kVp protocol. The mean volume computed tomography dose index of the 80-kVp (5.6 mGy) protocol was 23.3% lower than that of the 120-kVp (7.3 mGy) protocol.

Conclusion The use of the 80-kVp protocol improved overall venous attenuation, especially in perforating vein, and provided similarly high diagnostic image quality with a lower radiation dose when compared to the conventional 120-kVp protocol.

From the *Department of Radiology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Korea; and †Department of Radiology, Armed Forces Capital Hospital of Korea, Bundang-gu, Seongnam-si, Gyeonggi-do, Korea.

Received for publication March 20, 2012; accepted May 30, 2012.

Reprints: Joo Hee Kim, MD, Department of Radiology, Yonsei University College of Medicine, Gangnam Severance Hospital, 211 Eonju-ro, Gangnam-Gu, Seoul 135-720, Korea (e-mail:

The authors report no conflicts of interest.

Copyright © 2012 Wolters Kluwer Health, Inc. All rights reserved.