SOMATOM Definition Dual Energy Scanning

Authors: E. Hendrich, MD; A. Will, MD; St. Martinoff, MD
Department of: Radiology and Nuclearmedicine, German Heart Center, Munich, Germany

History

A 65 year-old woman presented with complaints about recurrent vertigo. Weeks ago, the leading stenosis in the right internal carotid artery (ICA) had been stented. During routinely performed ultrasound examination a stenosis was also seen in the left ICA. To verify these results and for planning of interventional PTA (percutanuous transluminal angioplasty) and stent positioning in the left ICA a CT-Angiography with Dual Energy technology has been accomplished subsequently.

Diagnosis

CT-Angiography proved the result of the ultrasound examination. A quite severe stenosis in the proximal left ICA, with cranio-caudal extension of 13 mm, due to a semicircular atheromatous plaque could be confirmed. A restenosis of the implanted stent in the proximal right ICA could be ruled out. Moreover, other profound arteriosclerotic alterations in the circle of willis could be excluded by CT-Angiography.

Comments

syngo DE Direct Angio delivers reliable information about vessel status and therefore plays an important role in vessel imaging. The subtraction of bone structures and parallel visualization of calcified plaque provides the detailed analysis of vessel lumen and plaque. A very positive effect is the comfortable integration of Dual Energy into the post processing procedure. Hence syngo DE Direct Angio has become an inherent part of our vascular imaging workflow.

Pictures 1 & 2: Excellent visualization of the Carotid syphon and the stenosis in the proximal left ICA with VRT and MIP technique
Picture 3: Quantitative stenosis evaluation in syngo InSpace AVA
Picture 4: Visualization of Plaque differentiation with DualEnergy

Examination Protocol