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KMID : 0880420130140030532
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Korean Journal of Radiology
2013 Volume.14 No. 3 p.532 ~ p.539
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Dual-Energy CT in the Assessment of Mediastinal Lymph Nodes: Comparative Study of Virtual Non-Contrast and True Non-Contrast Images
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Yoo Seon-Young
Kim Yoo-Kyung
Choi Mi-Joo
Shim Sung-Shine
Lee Jeong-Kyong
Baek Seung-Yon
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Abstract
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Objective: To evaluate the reliability of virtual non-contrast (VNC) images reconstructed from contrast-enhanced, dual-energy scans compared with true non-contrast (TNC) images in the assessment of high CT attenuation or calcification of mediastinal lymph nodes.
Materials and Methods: A total of 112 mediastinal nodes from 45 patients who underwent non-contrast and dual-energy contrast-enhanced scans were analyzed. Node attenuation in TNC and VNC images was compared both objectively, using computed tomography (CT) attenuation, and subjectively, via visual scoring (0, attenuation ≤ the aorta; 1, > the aorta; 2, calcification). The relationship among attenuation difference between TNC and VNC images, CT attenuation in TNC images, and net contrast enhancement (NCE) was analyzed.
Results: CT attenuation in TNC and VNC images showed moderate agreement (intraclass correlation coefficient, 0.612). The mean absolute difference was 7.8 ± 7.6 Hounsfield unit (HU) (range, 0-36 HU), and the absolute difference was equal to or less than 10 HU in 65.2% of cases (73/112). Visual scores in TNC and VNC images showed fair agreement (κ value, 0.335). Five of 16 nodes (31.3%) which showed score 1 (n = 15) or 2 (n = 1) in TNC images demonstrated score 1 in VNC images. The TNC-VNC attenuation difference showed a moderate positive correlation with CT attenuation in TNC images (partial correlation coefficient [PCC] adjusted by NCE: 0.455) and a weak negative correlation with NCE (PCC adjusted by CT attenuation in TNC: -0.245).
Conclusion: VNC images may be useful in the evaluation of mediastinal lymph nodes by providing additional information of high CT attenuation of nodes, although it is underestimated compared with TNC images.
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KEYWORD
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Dual-energy CT, Chest, Lymph nodes, Virtual non-contrast, Iodine subtraction
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