Portal vein and inferior vena cava

Discussion

Postoperative CT examination in patient with known liver cancer.

Spectral virtual low monoenergetic images increased attenuation value of portal vein and inferior vena cava to facilitate diagnostic evaluation.

Multiplanar reformation (MPR), volume rendering (VR)

Venous phase images show low luminal contrast leading to low diagnostic confidence. Spectral virtual low monoenergetic reconstructions improved attenuation of iodine, which led to improved opacification of inferior vena cava and the portal venous system. In addition, the spectral low monoenergetic reconstruction improved image quality by reducing noise.

Imaging of the venous system requires the injection of a larger dose of contrast agent to achieve satisfactory enhancement, and the conventional venous phase does not meet the requirements of portal venous and inferior vena cava imaging. Spectral virtual low monoenergetic reconstructions at 40 keV improved intravenous enhancement, facilitating high-quality venous imaging, reduced image noise, improved image quality, and improved depiction of abdominal organ lesions.

Injection protocol: Contrast concentration 300 mgI/mL, contrast volume 80 mL, flow rate 2.5 mL/s

Scanning protocol: Venous phase imaging, helical acquisition 65s after contrast injection

Conventional image MPR: Venous phase image shows low attenuation of inferior vena cava, with measured value of 125.4 HU, leading to poor depiction of the inferior vena cava and portal venous system. Note boundary of right adrenal space.

Conventional image VR: Venous phase image shows poor depiction of inferior vena cava and portal venous systems.

Spectral virtual monoenergetic 40 keV image, MPR: The CT value of the inferior vena cava lumen increased to 380.6 HU. Attenuation of the inferior vena cava and portal venous system is now good, and the portal venous tortuous vascular mass was observed. Note lower image noise compared to the conventional image, and the improved definition of right adrenal gland including the inner cystic necrotic area.

Spectral virtual monoenergetic 40 keV image, VR: The inferior vena cava and portal venous system can be clearly seen, showing portal venous distortion and dilation, with good vascular enhancement. The right adrenal gland is indicated in purple.

History