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Computed tomographic angiography (CTA) has been used recently for the evaluation of intracerebral aneurysms, but it is difficult to use this technique to visualize aneurysms near the base of the skull because of the presence of bone. So, subtracted CTA has been used to separate vessels from bony structures. However, we see some misregistration when using subtraction method because of the patient moving, the disaccord of the X-ray tube orbit between the mask image and the live image, the expanding focus, and the bed bending. So, attentioning the difference of bone CT number in any tube voltages, we examined to make the image containing less misregistration by changing the tube voltage of mask image. Making a sham blood vessel, we examined the bone misregistration, the blood vessel volume, and the smoothness when changing the tube voltages of mask images. Comparing with 120 kV, as the tube voltage of the mask image was 80 kV, the bone misregistration decreased significantly, however the blood vessel volume decreased. As for the tube voltage of 100 kV, the bone misregistration decreased significantly, and the blood vessel volume and the smoothness were not significantly different so we could get coordinative image of 120 kV. When the tube voltage of the mask image becomes lower than that of the live image and the effective energy becomes different, the effect of misregistration is less. This method deals with changing the tube voltage only. So, it may be easy to make volume rendering (VR) image and this method may be used in every facility.

Examination of Reducing Misregistration for Lower Tube Voltage of the Mask Image in CT Angiography Using Subtraction Method