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Updated: Nov 7, 2025
In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
Published on: February 16, 2016
Coronary Microvascular Dysfunction: PET, CMR and CT Assessment
Elisabetta Tonet1, Graziella Pompei1, Evelina Faragasso2
1Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, 44124 Cona, Italy.
Insights
Microvascular dysfunction causes chest pain and can be diagnosed using advanced imaging. Identifying this condition is key for effective medical management and improved patient outcomes.
Area of Science:
- Cardiology
- Medical Imaging
Background:
- Microvascular dysfunction is a significant cause of chest pain in patients with and without obstructive coronary artery disease.
- Accurate diagnosis is crucial for guiding treatment and improving prognosis.
Purpose of the Study:
- To summarize advanced imaging techniques for assessing microvascular dysfunction.
- To review current evidence on these modalities and their relation to invasive evaluations.
Main Methods:
- Overview of diagnostic capabilities of Positron Emission Tomography (PET).
- Discussion of emerging roles for Cardiovascular Magnetic Resonance (CMR) and Cardiac Computed Tomography (CCT).
Main Results:
- PET is the gold standard for diagnosing microvascular abnormalities.
- CMR and CCT are increasingly valuable for microcirculation assessment.
- Identifying microvascular disease is fundamental for characterizing patients with chest pain and no epicardial coronary disease.
Conclusions:
- Advanced imaging plays a vital role in diagnosing microvascular dysfunction.
- These techniques aid in patient characterization, medical strategy management, and prognosis improvement.
Abstract:
Microvascular dysfunction is responsible for chest pain in various kinds of patients, including those with obstructive coronary artery disease and persistent symptoms despite revascularization, or those with myocardial disease without coronary stenosis. Its diagnosis can be performed with an advanced imaging technique such as positron emission tomography, which represents the gold standard for diagnosing microvascular abnormalities. In recent years, cardiovascular magnetic resonance and cardiac computed tomography have demonstrated to be emerging modalities for microcirculation assessment. The identification of microvascular disease represents a fundamental step in the characterization of patients with chest pain and no epicardial coronary disease: its identification is important to manage medical strategies and improve prognosis. The present overview summarizes the main techniques and current evidence of these advanced imaging strategies in assessing microvascular dysfunction and, if present, their relationship with invasive evaluation.
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