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

  • Sung Min Ko
Part of the Medical Radiology book series (MEDRAD)


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.


Myocardial Perfusion Imaging Perfusion Defect Coronary Compute Tomography Angiography Fractional Flow Reserve Conventional Coronary Angiography 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



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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Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  1. 1.Department of Radiology, Konkuk University HospitalKonkuk University School of MedicineGwangjin-guKorea

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