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PURPOSE To investigate the assessing capability of dual-energy coronary CT angiography(DE-CCTA)using virtual monoenergetic(MoboE+)imaging at varying kiloelectron volt(keV)levels on the 3rd generation dual-source CT.METHOD AND MATERIALS All patients gave informed consent for our institutional review board-approved study.Twenty consecutive patients suspected coronary artery disease(CAD)with CarScore≥400 underwent DE-CCTA on a third-generation dual-source CT scanner.Contrast material(45 mL,370 mgI/mL),saline flush(45mL)and flow rate(4 ml/s)were kept equal for optimum comparability.DECT data were acquired with parameters as follows: Sn90 kV for tube A and Sn150 kV for tube B,and automatic exposure control was used in all patients.The Sn 90-kV and Sn150-kV images were then transferred to a workstation for the evaluation of DECT datasets.DE-CCTA MonoE+series ranging from 70 to 130 keV(10-keV intervals)were reconstructed.Signal intensity,noise and signal-to-noise ratio of multiple aortic root were evaluated.And stenosis of vessles containg calcium plaque was evaluated.RESULTS All the 20 patients(age: 67.5± 7.8 ys,M:F=11∶9)completely finished DE-CCTA.BMI,heart rate,calcium score and effective radiation dose were 25.5±2.2 kg/m2,61.6±7.0 bpm,915±476 and 3.8±1.2mSv,respectively.MonoE+series images indicated the CT value of aorta root gradually decreased with the increase of the energy spectrum,and SD of 70 keV series was the highest(18.1±2.5 Hu,P>0.001),while the other keV series had no significant differences.The SNR arrayed as follows: 70keV≈80keV>90keV>100keV>110keV>120keV≈130keV.Lower energy images showed that the lumen stenosis was more serious than the higher series because of blooming artifacts,which might lead to excessive evaluation.Four of the 20 patients did DSA examination and total of 9 vessels had calcified plaque,and the 90keV and 100keV images had highest coincidence rate(7/9).CONCLUSION For patients with high calcium score of coronary artery,DE-CCTA with monoenergy reconstruction could improve the accuracy of stenosis assessment,and 90keV-100keV was recommended.