Objective To investigate the image quality of virtual monoenergetic images(VMIs)of portal vein angiography and the clinical application value by using dual-layer detector spectral CT(DLCT)for routine upper abdominal angiography in cirrhotic patients.Methods We retrospectively analyzed 30 patients with liver cirrhosis who underwent routine upper abdominal angiography DLCT examination from January 2023 to July 2023.Conventional polyenergetic images(PEIs)and VMIs at 40-70 keV(VMI40,55,70,15-keV increments)were generated from portal venous phase(PVP).The noise,CT values,signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)of PVP in four groups were measured,and the overall image quality was scored and evaluated by two radiologists.Results The CT values(555.92±181.39),SNR(19.02±10.2)and CNR(28.01±15.24)of portal vein in VMI40 were higher than the other three groups.The difference was statistically significant(P＜0.01).The portal vein noise in 40keV group(24.94±8.54)was higher than that in 120KVp group(21.42±5.49)and other VMI groups.The scores of the two physicians were consistent(kappa values were 0.775 and 0.824).The agreement of the scores of the two radiologists was good(kappa values of 0.775 and 0.824).Conclusion The virtual monoenergetic 40 keV portal vein images showed the best images quality from conventional upper abdominal angiography with dual-layer detector spectral CT in cirrhotic patients,which can meet the clinical diagnostic requirements and be valuable in the diagnosis of portal vein disease.
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