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Erschienen in: The International Journal of Cardiovascular Imaging 1/2016

14.12.2015 | Original Paper

CT-based myocardial ischemia evaluation: quantitative angiography, transluminal attenuation gradient, myocardial perfusion, and CT-derived fractional flow reserve

verfasst von: Hyun Jung Koo, Dong Hyun Yang, Young-Hak Kim, Joon-Won Kang, Soo-Jin Kang, Jihoon Kweon, Hyun Jung Kim, Tae-Hwan Lim

Erschienen in: The International Journal of Cardiovascular Imaging | Sonderheft 1/2016

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Abstract

The detection of hemodynamically significant stenosis is important because ischemia-guided revascularization improves overall patient outcomes. Fractional flow reserve (FFR), which is measured during invasive coronary angiography, is regarded as the gold standard for determining hemodynamically significant coronary stenosis. Although coronary computed tomography angiography (CCTA) has been widely used to exclude significant coronary artery disease in patients with low to intermediate pretest probability, anatomic assessment by CCTA using diameter stenosis ≥50 % does not correlate well with the functional assessment of FFR. To overcome the weaknesses of conventional CCTA, such as its low specificity and positive predictive value, especially in patients with a small-diameter artery, poor image quality, or high calcium score, more sophisticated CCTA analysis methods have been developed to detect hemodynamically significant coronary stenosis. Studies that use the quantification of coronary plaque, transluminal attenuation gradient (TAG), CT myocardial perfusion (CTP), and CT-derived FFR have been conducted to validate their diagnostic performances, though each method has its pros and cons. This review provides details on the quantification of coronary plaque, TAG, CTP, and CT-derived FFR, including a definition of each, how to gather and interpret data, and the strengths and limitations of each. Further, we provide an overview of recent clinical studies.
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Metadaten
Titel
CT-based myocardial ischemia evaluation: quantitative angiography, transluminal attenuation gradient, myocardial perfusion, and CT-derived fractional flow reserve
verfasst von
Hyun Jung Koo
Dong Hyun Yang
Young-Hak Kim
Joon-Won Kang
Soo-Jin Kang
Jihoon Kweon
Hyun Jung Kim
Tae-Hwan Lim
Publikationsdatum
14.12.2015
Verlag
Springer Netherlands
Erschienen in
The International Journal of Cardiovascular Imaging / Ausgabe Sonderheft 1/2016
Print ISSN: 1569-5794
Elektronische ISSN: 1875-8312
DOI
https://doi.org/10.1007/s10554-015-0825-5

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