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Beyond stenosis detection: computed tomography approaches for determining the functional relevance of coronary artery

Carlo Nicola De Cecco1, Akos Varga-Szemes2, Felix G Meinel3

  • 1Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Drive, Charleston, SC 29425, USA; Department of Radiological Sciences, Oncology and Pathology, University of Rome "Sapienza" - Polo Pontino, Via Franco Faggiana 34, Latina 04100, Italy.

Radiologic Clinics of North America
|March 3, 2015
PubMed

Insights

Coronary computed tomography angiography (CCTA) offers anatomical detail but struggles with functional significance. New CT techniques aim to provide both anatomic and functional assessments of coronary artery disease in a single imaging session.

Area of Science:

  • Cardiovascular imaging
  • Medical diagnostics
  • Radiology

Background:

  • Coronary computed tomography angiography (CCTA) is a standard noninvasive method for evaluating coronary arteries.
  • CCTA, like invasive coronary angiography, primarily offers morphological information and has limitations in assessing the hemodynamic significance of coronary stenosis.

Purpose of the Study:

  • To explore emerging computed tomography (CT) techniques for the functional analysis of coronary lesions.
  • To highlight the potential of these new CT methods for a comprehensive assessment of coronary heart disease.

Main Methods:

  • Review of novel CT techniques including static and dynamic CT myocardial perfusion imaging.
  • Discussion of CT-based fractional flow reserve and transluminal attenuation gradient methods.

Main Results:

  • Emerging CT techniques offer the potential to evaluate the functional significance of coronary stenosis.
  • These methods complement traditional CCTA by adding hemodynamic information.

Conclusions:

  • New CT-based functional analysis methods are advancing the comprehensive assessment of coronary heart disease.
  • These techniques promise a single-modality approach for evaluating both anatomic and functional aspects of coronary artery disease.

Keywords:
Coronary CT angiographyCoronary artery diseaseDual-energy CTFractional flow reserveMyocardial perfusion imagingTransluminal attenuation gradient

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