Dynamic CT Myocardial Perfusion: The Role of Functional Evaluation in the Diagnosis of Coronary Artery Disease.
Agata ZdanowiczMaciej GuzinskiMichal PulaAgnieszka WitkowskaKrzysztof ReczuchPublished in: Journal of clinical medicine (2023)
Coronary computed tomography angiography (CTA) is a widely accepted, non-invasive diagnostic modality for the evaluation of patients with suspected coronary artery disease (CAD). However, a limitation of CTA is its inability to provide information on the hemodynamic significance of the coronary lesion. The recently developed stress dynamic CT perfusion technique has emerged as a potential solution to this diagnostic challenge. Dynamic CT myocardial perfusion provides information on the hemodynamic consequences of coronary stenosis and is used to detect myocardial ischemia. The combination of stress dynamic CT myocardial perfusion with CTA provides a comprehensive assessment that integrates anatomical and functional information. CT myocardial perfusion has been validated in several clinical studies and has shown comparable accuracy to Positron Emission Tomography (PET) and stress magnetic resonance imaging (MRI) in the diagnosis of hemodynamically significant coronary stenosis and superior performance to Single Photon Emission Computed Tomography (SPECT). More importantly, CTP-derived myocardial perfusion has been shown to have a strong correlation with FFR, and the use of CTP results in a reduction of negative catheterizations. In the context of suspected stable coronary artery disease, the CT protocol with dynamic perfusion imaging combined with CTA eliminates the need for additional testing, making it a convenient "one-stop-shop" method and an effective gatekeeper to an invasive approach.
Keyphrases
- computed tomography
- coronary artery disease
- positron emission tomography
- contrast enhanced
- magnetic resonance imaging
- dual energy
- image quality
- coronary artery
- coronary artery bypass grafting
- cardiovascular events
- percutaneous coronary intervention
- magnetic resonance
- heart failure
- pet ct
- randomized controlled trial
- diffusion weighted imaging
- type diabetes
- pet imaging
- healthcare
- stress induced
- photodynamic therapy
- aortic stenosis
- climate change
- mass spectrometry
- pulmonary embolism
- high resolution
- social media
- acute coronary syndrome
- human health