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In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
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Functional Information in Coronary Artery Disease: The Case of Computed Tomography Myocardial Perfusion

Klaus F Kofoed1,2,3, Mathias H Sørgaard4, Jesper J Linde4

  • 1Department of Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. kkofoed@dadlnet.dk.

Current Cardiology Reports
|October 27, 2017
PubMed

Insights

CT myocardial perfusion imaging, combined with coronary CT angiography (CCTA), enhances diagnosis of coronary artery disease (CAD) by identifying ischemia. This improves patient selection for interventions.

Area of Science:

  • Cardiovascular Imaging
  • Radiology
  • Diagnostic Techniques

Background:

  • Coronary artery disease (CAD) diagnosis relies on identifying myocardial ischemia.
  • Coronary CT angiography (CCTA) detects atherosclerotic lesions but may not always correlate with ischemia.
  • Accurate assessment of myocardial perfusion is crucial for guiding revascularization decisions.

Purpose of the Study:

  • To review the methodology and logistics of CT myocardial perfusion imaging.
  • To summarize current clinical evidence for CT myocardial perfusion in CAD.
  • To explore future directions for CT myocardial perfusion in clinical practice.

Main Methods:

  • CT myocardial perfusion imaging can be performed as an adjunct to CCTA.
  • It assesses myocardial blood flow at rest and during pharmacologic stress (e.g., adenosine).
  • Measurement principles are validated in experimental models and show concordance with other perfusion imaging modalities.

Main Results:

  • Combining CCTA with CT myocardial perfusion imaging improves diagnostic accuracy for CAD-associated ischemia.
  • CT myocardial perfusion can identify specific coronary lesions linked to ischemia.
  • This aids in selecting patients who may benefit from coronary revascularization.

Conclusions:

  • CT myocardial perfusion imaging is a valuable tool for assessing myocardial ischemia in patients with suspected or known CAD.
  • Its integration with CCTA enhances diagnostic capabilities, potentially optimizing treatment strategies.
  • Further research and clinical implementation can refine its role in cardiovascular medicine.
Abstract

Keywords:
Cardiac computed tomography angiographyChest painCoronary artery diseaseCoronary revascularizationMyocardial ischemiaMyocardial perfusion

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