CT Venography for Deep Vein Thrombosis Using a Low Tube Voltage (100 kVp) Setting Could Increase Venous Enhancement and Reduce the Amount of Administered Iodine

Abstract

ObjectiveTo investigate the validity of the 100 kVp setting in CT venography (CTV) in the diagnosis of deep vein thrombosis (DVT), and to evaluate the feasibility of reducing the amount of administered iodine in this setting.Materials and MethodsAfter receiving the contrast medium (CM) of 2.0 mL/kg, 88 patients underwent CTV of the pelvis and lower extremities by using one of four protocols: Group A, 120 kVp setting and 370 mgI/mL CM; group B, 120 kVp and 300 mgI/mL; group C, 100 kVp and 370 mgI/mL; group D, 100 kVp and 300 mgI/mL. The groups were evaluated for venous attenuation, vein-to-muscle contrast-to-noise ratio (CNRVEIN), DVT-to-vein contrast-to-noise ratio (CNRDVT), and subjective degree of venous enhancement and image quality.ResultsVenous attenuation and CNRVEIN were significantly higher in group C (144.3 Hounsfield unit [HU] and 11.9), but there was no significant difference between group A (118.0 HU and 8.2) and D (122.4 HU and 7.9). The attenuation value of DVT was not significantly different among the four groups, and group C had a higher absolute CNRDVT than the other groups. The overall diagnostic image quality and venous enhancement were significantly higher in group C, but there was no difference between groups A and D.ConclusionThe 100 kVp setting in CTV substantially help improve venous enhancement and CNRVEIN. Furthermore, it enables to reduce the amount of administered iodine while maintaining venous attenuation, as compared with the 120 kVp setting.

Qualitative evaluation of pulmonary CT angiography findings in pregnant and postpartum women with suspected pulmonary thromboembolism

“…There were evidences that optimizing the procedure by reducing kVp from 140 to 100 would improve the quality of the image and consequently the diagnosis process. [ 24 25 ] The mean of kVp in this study were 109 and 101 for pregnant and postpartum women, respectively.…”

Advanced imaging in acute and chronic deep vein thrombosis

“…They concluded that lower tube voltage CTV protocol showed significantly higher venous enhancement and contrast to noise ratio and image noise similar to the conventional 120 kVp protocol in spite of administering 18.6% less iodine by moderate concentration contrast media (300 mgI/mL) instead of high concentration contrast media (370 mgI/mL). The 100 kVp protocol had overall better diagnostic image quality for evaluating DVT by CTV and hence could provide higher diagnostic accuracy for evaluation of DVT (51).…”

“…To overcome these limitations, Cho et al investigated the role of low tube voltage (100 kVp) setting in CTV in diagnosis of DVT and evaluated the feasibility of reducing the amount of intravenously administered contrast (51). They concluded that lower tube voltage CTV protocol showed significantly higher venous enhancement and contrast to noise ratio and image noise similar to the conventional 120 kVp protocol in spite of administering 18.6% less iodine by moderate concentration contrast media (300 mgI/mL) instead of high concentration contrast media (370 mgI/mL).…”

Salvia miltiorrhiza prevents deep vein thrombosis via antioxidative effects in endothelial cells

“…This treatment aims to prevent thrombus propagation, and to reduce the risks of PE and DVT recurrence. However, anticoagulation therapy does not possess significant fibrinolytic activity, and patients with severe, extensive and proximal DVTs remain at high risk (15). In DVT treated with anticoagulants alone, it…”