CT first pass myocardial perfusion has been regarded for several years as the potential method to realize a complete evaluation of coronaropathy in a single CT examination. The high positive predictive value of coronary CTA for the detection of plaques is well established[1–3]. However, it is known that anatomic evaluation of stenosis is inaccurate in determining their hemodynamic significance especially for borderline lesions[4]. Thus, there is a real interest and need to add functional evaluation of stenosis by means of detection of myocardial hypoperfusion to...

Patients’ population Between January and July 2018, patients with clinically indicated coronary CT were randomized to undergo spectral coronary CT-angiography on a 64-row DLCT system with two different injection protocols. Exclusion criteria were age 50% and hypertrophy (myocardial thickness>15mm) were excluded from analysis. Reconstructions and images evaluation Conventional and iodine maps were reconstructed at 78% of the cardiac cycle. Reconstructions of 3mm thickness of iodine maps were oriented on shortaxis planes ( Fig. 1 ). Regions-of-interest (ROI) were manually drawn on the 16 myocardial segments...

Patients and plaques characteristics 30 and 30 patients for protocol A and B were included, respectively. The mean age was 51,2 ± 17,5 (18-77) for group A and 51,4 ± 18,7 (23-80) for group B; 67% and 80% of patients were males, respectively. In group A, 16 patients had coronary pathology for a total of 22 diseased vessels (19 with a 0-25% stenosis and 3 with a 25-50% stenosis). In group B, 12 patients had 17 diseased vessels with 14 stenosis in the range 0-25%...

At lower injection rates and contrast dose, first pass iodine concentration values calculated with spectral CT are significantly different in segments subtended by vessels without any coronary disease and vessels with plaques determining anatomically non-significant stenosis.

1. Bastarrika G, Lee YS, Huda W, Ruzsics B, Costello P, Schoepf UJ (2009) CT of Coronary Artery Disease. Radiology 253:317–338 2. Min JK, Shaw LJ, Devereux RB, Okin PM, Weinsaft JW, Russo DJ, Lippolis NJ, Berman DS, Callister TQ (2007) Prognostic Value of Multidetector Coronary Computed Tomographic Angiography for Prediction of All-Cause Mortality. J Am Coll Cardiol 50:1161–1170 3. Pundziute G, Schuijf JD, Jukema JW, Boersma E, de Roos A, van der Wall EE, Bax JJ (2007) Prognostic Value of Multislice Computed Tomography Coronary...