文摘
Objectives To evaluate image quality and diagnostic accuracy of selective monoenergetic reconstructions of late iodine enhancement (LIE) dual-energy computed tomography (DECT) for imaging of chronic myocardial infarction (CMI). Methods Twenty patients with a history of coronary bypass surgery underwent cardiac LIE-DECT and late gadolinium enhancement (LGE) magnetic resonance imaging (MRI). LIE-DECT images were reconstructed as selective monoenergetic spectral images with photon energies of 40, 60, 80, and 100?keV and the standard linear blending setting (M_0.6). Images were assessed for late enhancement, transmural extent, signal characteristics and subjective image quality. Results Seventy-nine myocardial segments (23?%) showed LGE. LIE-DECT detected 76 lesions. Images obtained at 80?keV and M_0.6 showed a high signal-to-noise ratio (15.9; 15.1), contrast-to-noise ratio (4.2; 4.0) and sensitivity (94.9?%; 92.4?%) while specificity was identical (99.6?%). Differences between these series were not statistically significant. Transmural extent of LIE was overestimated in both series (80?keV: 40?%; M_0.6: 35?%) in comparison to MRI. However, observers preferred 80?keV in 13/20 cases (65?%, κ--.634) over M_0.6 (4/20 cases) regarding subjective image quality. Conclusions Post-processing of LIE-DECT data with selective monoenergetic reconstructions at 80?keV significantly improves subjective image quality while objective image quality shows no significant difference compared to standard linear blending. Key Points -Late enhancement dual-energy CT allows for detection of chronic myocardial infarction. -Monoenergetic reconstructions at 80?keV significantly improve subjective image quality. -80?keV and standard linear blending reconstructions show no significant differences. -Extent of CMI detected with LIE-DECT is overestimated compared with MRI.