Kokawa Takanori, Kitagawa Kakuya, Nakamura Satoshi, Takafuji Masafumi, Oya Takashi, Sakuma Hajime
Department of Radiology, Mie University Hospital, Tsu, Japan.
Department of Advanced Diagnostic Imaging, Mie University Graduate School of Medicine, Tsu, Japan.
Insights Imaging. 2025 Mar 22;16(1):64. doi: 10.1186/s13244-025-01944-4.
Myocardial computed tomography late enhancement (CT-LE) is a valuable modality used for the assessment of myocardial infarction and fibrosis and is effective in detecting latent cardiac amyloidosis. However, the optimal acquisition mode for CT-LE remains unknown. Here, we compared single-energy shuttle mode and DE mode for improving the quality of CT-LE imaging using dual-source CT.
Fifteen patients with suspected or known ischemic heart disease underwent CT-LE imaging 5 min after coronary CT in both shuttle and dual-energy (DE) modes. In DE mode, virtual monoenergetic images at various keVs were reconstructed, and extracellular volume (ECV) was quantified using iodine-specific images. For shuttle mode, ECV was assessed by subtracting the volume from pre-contrast images from CT-LE after non-rigid registration.
In DE mode, signal-noise-to-ratio was the highest at 70 keV, but it was still lower than that in shuttle mode (p < 0.001). Contrast-noise-to-ratio was the highest on DE mode at 40 keV and was comparable with that in shuttle mode (p = 0.51). Interobserver agreement for infarct detection was higher in shuttle mode (kappa = 0.981) compared to DE mode (kappa = 0.808). Global ECV was comparable between shuttle and DE modes (p = 0.96). However, the coefficient of variation of segmental ECV was significantly lower in shuttle mode (p < 0.001).
Shuttle mode CT-LE demonstrates superior image quality, better agreement in infarct detection, and ECV consistency in comparison to DE mode, suggesting its potential as the preferred approach for CT-LE imaging using dual-source CT despite limited z-axis coverage of 10.5 cm.
CT late enhancement imaging in shuttle mode provides superior image quality and consistent extracellular volume measurements compared to dual-energy mode, highlighting its potential as the preferred acquisition method for CT late enhancement imaging in dual-source CT.
Shuttle mode and dual-energy acquisition are compared for optimal myocardial CT-late enhancement (CT-LE) imaging. Shuttle mode can provide better image quality and more consistent extracellular volume measurements. Despite limited coverage, shuttle mode may be preferred for myocardial CT-LE imaging.
心肌计算机断层扫描延迟强化（CT-LE）是用于评估心肌梗死和纤维化的一种有价值的方法，并且在检测潜在的心脏淀粉样变性方面有效。然而，CT-LE的最佳采集模式仍不清楚。在此，我们比较了单能量穿梭模式和双能量模式，以使用双源CT提高CT-LE成像质量。
15例疑似或已知缺血性心脏病患者在冠状动脉CT检查后5分钟，分别采用穿梭模式和双能量（DE）模式进行CT-LE成像。在DE模式下，重建不同keV的虚拟单能量图像，并使用碘特异性图像对细胞外容积（ECV）进行定量。对于穿梭模式，通过非刚性配准后从CT-LE的对比前图像中减去容积来评估ECV。
在DE模式下，70 keV时的信噪比最高，但仍低于穿梭模式（p<0.001）。40 keV时DE模式下的对比噪声比最高，且与穿梭模式相当（p = 0.51）。与DE模式（kappa = 0.808）相比，穿梭模式下梗死灶检测的观察者间一致性更高（kappa = 0.981）。穿梭模式和DE模式之间的整体ECV相当（p = 0.96）。然而，穿梭模式下节段性ECV的变异系数显著更低（p<0.001）。
与DE模式相比，穿梭模式CT-LE显示出更高的图像质量、梗死灶检测方面更好的一致性以及ECV一致性，这表明尽管其z轴覆盖范围有限，仅10.5 cm，但它仍有潜力成为使用双源CT进行CT-LE成像的首选方法。
与双能量模式相比，穿梭模式的CT延迟强化成像提供了更高的图像质量和一致的细胞外容积测量结果，突出了其作为双源CT中CT延迟强化成像首选采集方法的潜力。
比较穿梭模式和双能量采集以实现最佳心肌CT延迟强化（CT-LE）成像。穿梭模式可提供更好的图像质量和更一致的细胞外容积测量结果。尽管覆盖范围有限，但穿梭模式可能是心肌CT-LE成像的首选。
