Vascular Applications of Dual-Energy Computed Tomography.

Dual- or multi-energy CT imaging provides several advantages over conventional CT in the context of vascular imaging. Specific advantages include the use of low-energy virtual monoenergetic images (VMIs) to boost iodine attenuation to salvage suboptimal enhanced studies, perform low-contrast material dose studies, and increase conspicuity of small vessels and lesions. Alternatively, high-energy VMIs reduce artifacts caused by some metals, endoprosthesis, calcium blooming, and beam hardening. Virtual non-contrast (VNC) images reduce radiation dose by eliminating the need for a true non-contrast acquisition in multiphasic CT studies. Iodine maps can be used to evaluate perfusion of tissues and lesions.

CTA of Acute Pulmonary Embolism: Best Practices.

Pulmonary CTA is a commonly performed study and the radiologist's role is not limited to simply producing a report. The process from identifying the appropriate patients who will benefit from the study to improving performance in the radiology department requires the radiologist's involvement, expertise, and leadership. The focus of this narrative review is to highlight the different steps and the ways to improve the quality in the assessment of thromboembolic disease where the radiologists can have an impact. This article provides an update on the commonly used and more recently published clinical decision tools, specific parameter adjustments of pulmonary CTA for more challenging patients and potential improvement for the radiology department.