Non-linear blending of dual-energy CT data improves depiction of late iodine enhancement in chronic myocardial infarction.

To compare non-linear and linear blending of cardiac dual-energy computed tomography (DECT) for optimal visualization of late iodine enhancement (LIE) in patients with chronic myocardial infarction (CMI). LIE-DECT data from 20 patients with known CMI were retrospectively analyzed. Images were reconstructed using non-linear blending center and width settings in the range of 0-500. Linear blending was performed with weighting factors 0.8 (80% 100 kV, 20% 140 kV), 0.6 and 0.3. 100-/140-kV data and blended images were analyzed. Contrast and percentage signal differences between infarcted and healthy myocardium and the left ventricle blood pool were computed. Statistical analysis was performed using repeated-measures analysis of variance and post hoc t tests. Non-linear blending showed the highest signal differences for all contrasts and analyses. Repeated-measures ANOVA tests confirmed the statistical differences between the investigated blending techniques (P < 0.01). Paired-samples post hoc t tests confirmed the significance of these results (P < 0.04). The ideal non-linear blending settings for best demarcation of CMI from healthy myocardium were a center of 65.8 ± 23.2 and a width of 0.0 ± 0.0. Non-linear blending of LIE-DECT improves display of LIE in patients with CMI in comparison with linear blending and non-post-processed image data from 100-/140-kV.