Optimization of head and neck vascular CT angiography using variable rate bolus tracking technique and third-generation dual-source CT dual-energy scanning.

Objective: To evaluate the effectiveness of the variable rate bolus tracking technique combined with third-generation dual-source CT dual-energy scanning in enhancing the quality of head and neck vascular CT angiography (CTA).

Methods: We conducted a retrospective analysis of 202 patients who underwent head and neck vascular CTA using a third-generation dual-source CT with dual-energy scanning. Patients were divided based on the contrast injection method into two groups: the variable-rate bolus tracking group (Group A, n = 100) and the fixed flow rate group (Group B, n = 102). We compared subjective image quality, venous artifacts, and objective image quality parameters between the two groups.

Results: The amount of contrast agent used in Group A was significantly lower than in Group B. Additionally, mean attenuation values of arterial segments in Group A were markedly lower than those in Group B. Compared to Group B, attenuation values of the intracranial venous sinuses, right jugular vein, superior vena cava, right subclavian vein, and left jugular vein in Group A showed significant reductions. No significant difference was observed in the subjective image quality between the two groups. However, venous artifact in the right subclavian vein was significantly diminished in Group A.

Conclusion: The application of the variable rate bolus tracking technique alongside third-generation dual-source CT dual-energy scanning in head and neck vascular CTA can achieve high-quality imaging while reducing contrast agent dosage. It enhances the attenuation contrast of intracranial arteries and veins and minimizes residual contrast and artifacts in the right subclavian vein.