Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

Dual-Energy Computed Tomography for Evaluating Acute Brain Infarction of Middle Cerebral Artery Territories

Optimization of Voltage Settings in Virtual Monoenergetic Imaging

Yoshida, Morikatsu, MD, PhD*; Nakaura, Takeshi, MD, PhD; Tanoue, Shota, MD*; Takada, Sentaro, MD*; Inoue, Taihei, MD; Uetani, Hiroyuki, MD, PhD; Harada, Kazunori, MD, PhD; Yamashita, Yasuyuki, MD, PhD

Journal of Computer Assisted Tomography: May/June 2019 - Volume 43 - Issue 3 - p 460–466
doi: 10.1097/RCT.0000000000000869

Objective To evaluate the optimal virtual monochromatic energy in dual-energy computed tomography for differentiating between infarcted areas and normal brain parenchyma.

Methods We enrolled 29 patients with middle cerebral artery acute brain infarction of who underwent examination by dual-energy computed tomography. We calculated the contrast-to-noise ratio (CNR) between white or gray matter and the infarcted area (CNR(W-I) and CNR(G-I), respectively) and normalized CNRs. From the normalized CNRs, we assessed which monochromatic energy gave the best balance between the infarcted area and normal brain parenchyma. The 70-keV images were used for comparison.

Results The 99-keV images demonstrated the best balance between the infarction and normal brain parenchyma. In quantitative analysis, the 99-keV images were not inferior to the 70-keV images. (CNR(G-I), 1.92 ± 0.80 vs 2.00 ± 0.70, respectively [P = 0.16]; CNR(W-I), 0.52 ± 0.72 vs 0.40 ± 0.64, P < 0.01, respectively).

Conclusions Monochromatic 99-keV energy images may be optimal for evaluating middle cerebral artery acute brain infarction.

From the *Department of Radiology, Amakusa Medical Center, Amakusa;

Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto; and

Department of Surgery, Amakusa Medical Center, Amakusa, Japan.

Received for publication November 5, 2018; accepted January 11, 2019.

Correspondence to: Morikatsu Yoshida, MD, PhD, Department of Radiology, Amakusa Medical Center, 854-1 Jikiba, Kameba, Amakusa City, Kumamoto, Japan 863-0046 (e-mail:

The authors declare no conflict of interest.

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.