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Computed tomographic evaluation of myocardial ischemia.
| Content Provider | Europe PMC |
|---|---|
| Author | Tanabe, Yuki Kurata, Akira Matsuda, Takuya Yoshida, Kazuki Baruah, Dhiraj Kido, Teruhito Mochizuki, Teruhito Rajiah, Prabhakar |
| Abstract | Myocardial ischemia is caused by a mismatch between myocardial oxygen consumption and oxygen delivery in coronary artery disease (CAD). Stratification and decision-making based on ischemia improves the prognosis in patients with CAD. Non-invasive tests used to evaluate myocardial ischemia include stress electrocardiography, echocardiography, single-photon emission computed tomography, and magnetic resonance imaging. Invasive fractional flow reserve is considered the reference standard for assessment of the hemodynamic significance of CAD. Computed tomography (CT) angiography has emerged as a first-line imaging modality for evaluation of CAD, particularly in the population at low to intermediate risk, because of its high negative predictive value; however, CT angiography does not provide information on the hemodynamic significance of stenosis, which lowers its specificity. Emerging techniques, e.g., CT perfusion and CT-fractional flow reserve, help to address this limitation of CT, by determining the hemodynamic significance of coronary artery stenosis. CT perfusion involves acquisition during the first pass of contrast medium through the myocardium following pharmacological stress. CT-fractional flow reserve uses computational fluid dynamics to model coronary flow, pressure, and resistance. In this article, we review these two functional CT techniques in the evaluation of myocardial ischemia, including their principles, technology, advantages, limitations, pitfalls, and the current evidence.Electronic supplementary materialThe online version of this article (10.1007/s11604-020-00922-8) contains supplementary material, which is available to authorized users. |
| Related Links | https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC7186254&blobtype=pdf |
| ISSN | 18671071 |
| Journal | Japanese Journal of Radiology [Jpn J Radiol] |
| Volume Number | 38 |
| DOI | 10.1007/s11604-020-00922-8 |
| PubMed Central reference number | PMC7186254 |
| Issue Number | 5 |
| PubMed reference number | 32026226 |
| e-ISSN | 1867108X |
| Language | English |
| Publisher | Springer Singapore |
| Publisher Date | 2020-02-05 |
| Publisher Place | Singapore |
| Access Restriction | Open |
| Rights License | Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. © The Author(s) 2020 |
| Subject Keyword | Computed tomography Coronary artery disease Myocardial ischemia Myocardial perfusion Fractional flow reserve |
| Content Type | Text |
| Resource Type | Article |
| Subject | Radiology, Nuclear Medicine and Imaging |
