SECT and DECT coronarography

Abstract

Coronary artery disease is an atherosclerotic disease of the coronary arteries with consequent development of ischemic heart disease and is one of the leading causes of death in developed and developing countries. The “golden” standard in the diagnosis of coronary disease is invasive coronarography, but with the development of coronary CT angiography, a sub-millimetre precise assessment of the anatomy of coronary arteries and heart has been made possible. While in the earlier stages, SECT devices were used for the needs of coronary CT angiography with synchronization with the ECG, the development of DECT devices enabled a significant rise in the performance of coronary CT angiography in the form of a better assessment of anatomy and stenoses of the coronary arteries caused by plaque, the possibility of assessing heart perfusion, obtaining an image with a minimal amount of artifacts, a smaller amount of applied iodine contrast agent, better characterization of the atherosclerotic plaque and its components, and all of the above with a lower radiation dose for the patient. While most of the conducted research speaks in favour of DECT devices versus SECT devices, the issue of inadequate utilization of the numerous possibilities of DECT devices in everyday clinical practice remains. The DECT technique can be implemented in several ways, depending on the structure of the DECT device (on the number of radiation sources, the structure/arrangement of detectors, or the use of filters), but the question of which type of DECT technique/device to use depends on the disadvantages and advantages of individual devices as well as on the final goal of diagnostic procedures.