OBJ ECTIVE. The purpose of this study was to investigate the vascular enhancement and image quality of pulmonary CT angiography performed with lower peak kilovoltage settings in a large patient sample.
MATERIALS AND METHODS. This retrospective study was approved by our insti¬tutional review board, which waived the requirement for informed consent. Four hundred patients believed to have a pulmonary embolism were studied. All patients underwent 16- or 64-MDCT with automatic tube current modulation. The 200 patients in the standard peak kilovoltage group (mean age, 57 years; range, 22-95 years) underwent MDCT at 130 or 120 kVp. The 200 patients in the low peak kilovoltage group (mean age, 56 years; range, 21-92 years) underwent MDCT at 110 or 100 kVp. Vascular enhancement was evaluated by mea¬surement of the attenuation value in the main pulmonary artery and segmental and subseg-mental arteries. Image noise was quantified by measurement of the SD of the attenuation val¬ue in the main pulmonary artery. One blinded radiologist assessed image quality using visual scores. Wilcoxons rank test was used to evaluate differences between the groups.
RESULTS. Mean vascular enhancement in the main pulmonary artery had significantly higher attenuation values in the low peak kilovoltage group (376.1 ± 102.9 HU) than in the standard peak kilovoltage group (309.2 ± 94.8 HU) (p
CONCLUSION. Lowering kilovoltage improved vascular enhancement without dete¬rioration of image quality. The results of our study confirm previously reported preliminary findings.
