Dual energy CT angiography plus CT perfusion in the accurate diagnosis and treatment of coronary artery disease:initial experience

WEI Xianglei; YOU Kezeng

Abstract：Objective To evaluate the combination of dual energy CT angiography (DE-CTA) and dual energy CT perfusion (DE-CTP) in the accurate diagnosis and treatment of coronary artery disease.Methods Thirty-one patients with suspected or known coronary artery disease were examined using dual energy CT.The reconstructed DE-CTA and DE-CTP images were used for detecting coronary stenosis and perfusion defects with ICA and SPECT as the reference standard.The performance of coronary DE-CTA alone, DE-CTP alone, and the combination of both were assessed by calculating sensitivity, specificity, positive and negative predictive values.DE-CTA and DE-CTP results were used to guide the stent choice.Results DE-CTA identified in 42 coronary artery stenosis (≥50%).DE-CTP diagnosed 45 coronary perfusion defects.DE-CTA plus DE-CTP diagnosed 50 arteries stenosis.Using ICA as a reference, the sensitivity, specificity, positive predictive value, and negative predictive value, accuracy of coronary DE-CTA were 84.8%(39/46), 95.2%(59/62), 92.9%(39/42), 89.4%(59/66), 90.7%(98/108).The values for coronary DE-CTP were 78.3%(36/46), 85.7%(54/63), 80.0%(36/45), 84.4%(54/64), 83.3%(90/108).The values for coronary combination of DE-CTA and DE-CTP yielded sensitivity of 95.7%(45/47), specificity of 89.2%(58/65), PPV of 86.5%(45/52), NPV of 96.7%(58/60) and accuracy of 92%(103/112).Conclusion DECT can provide perfusion blood volume information as well as vessel coronary artery anatomy information in one scan.DECT can improve diagnosis of CAD and guide the choice of coronary artery stent, which can achieve accurate diagnosis and treatment.