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CT Evaluation of the Myocardial Blood Supply: Dual-Source Dual-Energy CT

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Book cover CT Imaging of Myocardial Perfusion and Viability

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

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Abstract

With dual-source CT in dual-energy mode, two X-ray tubes are operated independently at different voltages, acquiring two data sets showing different attenuation levels. An “iodine distribution map” is used for the assessment of myocardial blood pool status by analyzing iodine distribution within the myocardium based on the specific absorption characteristics of iodine for high and low X-ray energy spectra. Contrast-enhanced dual-energy computed tomography (DECT) perfusion with the patient at rest enables the evaluation of changes in the status of the myocardial blood supply. Rest DECT iodine distribution maps make hypoperfused myocardium more conspicuous and assist in the identification of areas exhibiting reversible myocardial ischemia. Rest DECT has thus expanded the clinical application of multidetector CT, as a “one stop shop” imaging modality to identify both coronary artery disease and myocardial blood pool deficits in a single examination. Stress DECT perfusion has the potential to become a robust clinical tool for the detection of myocardial ischemia. The combined approach of coronary CT angiography and stress DECT perfusion allows identification of hemodynamically significant coronary lesions in high-risk patients with a large calcified plaque burden or stents. This chapter provides a protocol setup and the characteristic features of dual-source DECT, and derives its benefits and limitations for DECT myocardial perfusion.

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Acknowledgments

The author sincerely thanks Dr. Meong Gun Song, Department of Thoracic Surgery at Konkuk University Medical Center, Dr. Tae-Hwan Lim, Department of Radiology at Asan Medical Center, Dr. Bernhard Krauss, Jungmin Hwang, and the CT technologists and the Radiology Department nursing staff at Konkuk University Medical Center.

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Authors and Affiliations

  1. Department of Radiology, Konkuk University Hospital, Konkuk University School of Medicine, Gwangjin-gu, Seoul, Korea

    Sung Min Ko

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  1. Sung Min Ko
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Correspondence to Sung Min Ko .

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Editors and Affiliations

  1. Center for Advanced Imaging Research (CAIR), Medical University of South Carolina Dept. Radiology, Charleston, South Carolina, USA

    U. Joseph Schoepf

  2. Ludwig-Maximilians-University Munich, Munich, Bayern, Germany

    Fabian Bamberg

  3. Department of Cardiology, Royal Liverpool and Broadgreen Universit, Liverpool, United Kingdom

    Balazs Ruzsics

  4. University Medical Center Groningen Center for Medical Imaging, Groningen, The Netherlands

    Rozemarijn Vliegenthart

  5. Sunnybrook Health Sciences Centre, Cardiothoracic Imaging Division, Department of Medical Imaging, Toronto, Ontario, Canada

    Gorka Bastarrika

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© 2012 Springer-Verlag Berlin Heidelberg

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Ko, S.M. (2012). CT Evaluation of the Myocardial Blood Supply: Dual-Source Dual-Energy CT. In: Schoepf, U., Bamberg, F., Ruzsics, B., Vliegenthart, R., Bastarrika, G. (eds) CT Imaging of Myocardial Perfusion and Viability. Medical Radiology(). Springer, Berlin, Heidelberg. https://doi.org/10.1007/174_2012_766

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  • DOI: https://doi.org/10.1007/174_2012_766

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-33878-6

  • Online ISBN: 978-3-642-33879-3

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