Selection method for two contrast media for use in a dual-energy CT examination, contrast media combination and generation of CT images using a contrast media combination and different energy spectra

1. A method for selecting two contrast agents to be used in a dual energy CT (Computed Tomography) examination of a patient, the method comprising:

scanning the patient taking into account at least two different radiation spectra and reconstructing a first image on the basis of a first radiation spectrum of the at least two different radiation spectra and a second image on the basis of a second radiation spectrum of the at least two different radiation spectra;

determining an HU (Hounsfield Unit) value diagram from the first and second image;

determining a base gradient as a gradient of a connecting line between a first material or a first tissue type and a second material or second tissue type in the HU value diagram of the energy-specific HU values;

selecting a first contrast agent from a number of contrast agents, each with a known enhancement gradient, with an enhancement gradient which is greater than the determined base gradient;

selecting a second contrast agent, the enhancement gradient of which lies in a significance region of the determined base gradient; and

generating CT images using the first and second contrast agents.

2. The method as claimed in claim 1 , wherein the significance region is determined at least in respect of a subsequently performed material decomposition method, a utilized examination dose, an observed energy spectra and properties of the CT system.

3. The method as claimed in claim 2 , wherein a glandular tissue is used as first tissue type.

4. The method as claimed in claim 2 , wherein a liver tissue is used as first tissue type.

5. The method as claimed in claim 2 , wherein a fatty tissue is used as second tissue type.

6. The method as claimed in claim 2 , wherein air is used as second material.

7. The method as claimed in claim 1 , wherein a glandular tissue is used as first tissue type.

8. The method as claimed in claim 1 , wherein a liver tissue is used as first tissue type.

9. The method as claimed in claim 1 , wherein a fatty tissue is used as second tissue type.

10. The method as claimed in claim 1 , wherein air is used as second material.

11. The method as claimed in claim 1 , wherein the base gradient is determined from a multiplicity of CT liver examinations with different degrees of pathological fatty metamorphosis of liver.

12. The method as claimed in claim 1 , wherein an iodine-containing contrast agent is selected as first contrast agent.

13. The method as claimed in claim 12 , wherein a combination of at least two lanthanides is selected in the second contrast agent.

14. The method as claimed in claim 1 , wherein a contrast agent with components from the group of the lanthanides is selected as second contrast agent.

15. The method as claimed in claim 1 , wherein a contrast agent which accumulates in the cardiovascular system is selected as first contrast agent.

16. The method as claimed in claim 1 , wherein a contrast agent which accumulates in cells of the first tissue type is selected as second contrast agent.

17. A method for generating CT (Computed Tomography) images of a patient having two different contrast agents comprising:

scanning the patient using a CT system, taking into account at least two different radiation spectra and reconstructing a first image on the basis of a first radiation spectrum of the at least two different radiation spectra and a second image on the basis of a second radiation spectrum of the at least two different radiation spectra;

determining an HU (Hounsfield Unit) value diagram from the first and second image;

wherein the second contrast of the two different contrast agents has an enhancement whose gradient in the HU value diagram corresponds to the radiation spectra of the gradient between two different materials or tissue types used in this HU value diagram,

generating a third image solely comprising a local concentration of the first contrast agent and generating a fourth image comprising the materials or tissue types, including a local concentration of the second contrast agent, by solving linear systems of equations for each pixel or of the first and second images, which describe the relationship between absorption and components and concentration of the two tissue types and the first contrast agent; and

output of at least one of the third and fourth image.

18. The method as claimed in claim 17 , wherein the contrast agents are selected according to a method for selecting two contrast agents to be used in a dual energy CT examination of a patient comprising:

scanning the patient taking into account at least two different radiation spectra and reconstructing the first image on the basis of a first radiation spectrum of the at least two different radiation spectra and the second image on the basis of a second radiation spectrum of the at least two different radiation spectra;

determining an HU value diagram from the first and second images;

determining a base gradient as a gradient of a connecting line between a first material or a first tissue type and a second material or second tissue type in the HU value diagram of the energy-specific HU values;

selecting a first contrast agent from a number of contrast agents, each with a known enhancement gradient, with an enhancement gradient which is greater than a determined base gradient; and

selecting a second contrast agent, the enhancement gradient of which lies in a significance region of the determined base gradient.

19. The method as claimed in claim 18 , wherein the following linear system of equations is solved for each pixel/voxel:

x E1 =c K1 *x K1,E1 +f*x G1,E1 +(1− f )* x G2,E1

x E2 =c K1 *x K1,E2 +f*x G1,E2 +(1− f )* x G2,E2

with the following variables being used:

f=proportion of the first tissue type G 1 ,

(1−f)=proportion of the second tissue type G 2 ,

c K1 =concentration of the first contrast agent K 1 ,

x K1,E1 =known X-ray attenuation value of the first contrast agent K 1 in respect of the first energy spectrum E 1 ,

x K1,E2 =known X-ray attenuation value of the first contrast agent K 1 in respect of the second energy spectrum E 2 ,

x G1,E1 =known X-ray attenuation value of the first material or the first tissue type G 1 in respect of the first energy spectrum E 1 ,

x G1,E2 =known X-ray attenuation value of the first material or the first tissue type G 1 in respect of the second energy spectrum E 2 ,

x G2,E1 =known X-ray attenuation value of the second material or the second tissue type G 2 in respect of the first energy spectrum E 1 ,

x G2,E2 =known X-ray attenuation value of the second material or the second tissue type G 2 in respect of the second energy spectrum E 2 .

20. The method as claimed in claim 17 , wherein the following linear system of equations is solved for each pixel/voxel:

x E1 =c K1 *x K1,E1 +f*x G1,E1 +(1− f )* x G2,E1

x E2 =c K1 *x K1,E2 +f*x G1,E2 +(1− f )* x G2,E2

with the following variables being used:

f=proportion of the first tissue type G 1 ,

(1−f)=proportion of the second tissue type G 2 ,

c K1 =concentration of the first contrast agent K 1 ,

x K1,E1 =known X-ray attenuation value of the first contrast agent K 1 in respect of the first energy spectrum E 1 ,

x K1,E2 =known X-ray attenuation value of the first contrast agent K 1 in respect of the second energy spectrum E 2 ,

x G1,E1 =known X-ray attenuation value of the first material or the first tissue type G 1 in respect of the first energy spectrum E 1 ,

x G1,E2 =known X-ray attenuation value of the first material or the first tissue type G 1 in respect of the second energy spectrum E 2 ,

x G2,E1 =known X-ray attenuation value of the second material or the second tissue type G 2 in respect of the first energy spectrum E 1 ,

x G2,E2 =known X-ray attenuation value of the second material or the second tissue type G 2 in respect of the second energy spectrum E 2 .

21. The method as claimed in claim 17 , wherein measurements are performed with two different energy spectra of the utilized radiation with at least one detector integrating over at least the used energy ranges in order to differentiate an absorption property of the utilized contrast agents with respect to different energy spectra.

22. The method as claimed in claim 17 , wherein measurements are performed with one energy spectrum of the utilized radiation and with at least one detector selective at at least two different energy ranges in order to differentiate the absorption property of the utilized contrast agents with respect to different energy spectra.

23. A method of selecting a combination of two contrast agents, provided for application in a CT (Computed Tomography) examination of a patient comprising:

scanning the patient using a CT system, taking into account at least two different radiation spectra and discretely examine the energy spectra for assessing the proportion of a first and a second tissue type or material, with a connecting line between the first and second tissue type or material in an HU (Hounsfield Unit) value diagram of the radiation spectra;

determining a base gradient as the gradient of the connecting line;

selecting a first contrast agent having a gradient in respect of the at least two energy spectra in the HU value diagram, the gradient being greater than the base gradient;

selecting a second contrast agent having a gradient in respect of the at least two energy spectra in the HU value diagram, the gradient lying in a significance region of the base gradient; and

generating CT images using the first and second contrast agents.

24. The method as claimed in claim 23 , wherein at least one contrast agent comprises a single lanthanide and has the desired enhancement.

25. The method as claimed in claim 23 , wherein at least one contrast agent consists of a mixture of a plurality of contrast agent components with at least differing lanthanides, wherein the individual contrast agent components have the same pharmacokinetic properties and, in total, the desired enhancement.

26. The method as claimed in claim 23 , wherein at least one contrast agent comprises a molecular complex which is occupied by different contrast-providing elements with a predetermined stoichiometric ratio such that the desired enhancement is attained.

27. A method of selecting a combination of two contrast agents as claimed in claim 23 for generating CT images of a patient having two different contrast agents, wherein the second contrast of the two different contrast agents has an enhancement whose gradient in an HU value diagram corresponds to the radiation spectra of the gradient between two different materials or tissue types used in this HU value diagram, the method comprising:

scanning the patient using a CT system, taking into account at least two different radiation spectra and reconstructing a first image on the basis of a first radiation spectrum of the at least two different radiation spectra and a second image on the basis of a second radiation spectrum of the at least two different radiation spectra;

generating a third image solely comprising a local concentration of the first contrast agent and generating a fourth image comprising the materials or tissue types, including a local concentration of the second contrast agent, by solving linear systems of equations for each pixel or voxel of the first and second images, which describe the relationship between absorption and components and concentration of the two tissue types and the first contrast agent; and

output of at least one of the third and fourth image.