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In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
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Stress myocardial perfusion: imaging with multidetector CT

Alexia Rossi1, Daphne Merkus, Ernst Klotz

  • 1From the Departments of Radiology (A.R., N.M., P.J.d.F., G.P.K.) and Experimental Cardiology (D.M.), Erasmus Medical Center, 's-Gravendijkwal 230, 3015 CE Rotterdam, the Netherlands; and Siemens Healthcare, Forchheim, Germany (E.K.).

Radiology
|December 21, 2013
PubMed

Insights

Computed tomographic (CT) coronary angiography can detect coronary stenosis but struggles with functional significance. Stress myocardial perfusion CT imaging offers a promising solution for evaluating myocardial ischemia, improving diagnostic accuracy when combined with CT coronary angiography.

Area of Science:

  • Cardiovascular imaging
  • Radiology
  • Medical diagnostics

Background:

  • Computed tomographic (CT) coronary angiography is limited in assessing the functional significance of coronary stenosis.
  • Anatomic and functional information is crucial for guiding patient care in coronary artery disease.
  • Myocardial ischemia assessment often requires additional functional testing beyond CT coronary angiography.

Purpose of the Study:

  • To review the physiology of coronary circulation and myocardial perfusion.
  • To describe technical aspects, challenges, and modeling for CT perfusion imaging.
  • To discuss recent advances, interpretation, and future research in CT perfusion.

Main Methods:

  • Review of current literature on CT coronary angiography and myocardial perfusion.
  • Discussion of CT perfusion imaging principles, including physiology and technical prerequisites.
  • Analysis of advancements in CT scanner technology and perfusion protocols.

Main Results:

  • Stress myocardial perfusion CT imaging can evaluate myocardial ischemia during vasodilator stress.
  • Combining stress myocardial perfusion CT with CT coronary angiography improves diagnostic accuracy compared to CT coronary angiography alone.
  • Optimization of CT perfusion acquisition protocols, including parameters, contrast injection, and radiation dose, is necessary.

Conclusions:

  • Stress myocardial perfusion CT imaging shows potential for assessing myocardial ischemia and improving diagnostic accuracy.
  • Further research is required to optimize CT perfusion protocols and establish clinical utility.
  • CT perfusion imaging, combined with CT coronary angiography, may offer a comprehensive noninvasive assessment of coronary artery disease.

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