Erschienen in:

20.12.2024 | Cardiac Radiology

State of the art of CT myocardial perfusion

verfasst von: Giuseppe Muscogiuri, Pierpaolo Palumbo, Kakuya Kitagawa, Satoshi Nakamura, Alberto Senatieri, Carlo Nicola De Cecco, Gabrielle Gershon, Gregorio Chierchia, Jessica Usai, Daniele Sferratore, Tommaso D’Angelo, Marco Guglielmo, Serena Dell’Aversana, Sonja Jankovic, Rodrigo Salgado, Luca Saba, Riccardo Cau, Paolo Marra, Ernesto Di Cesare, Sandro Sironi

Erschienen in: La radiologia medica | Ausgabe 3/2025

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Abstract

Coronary computed tomography angiography (CCTA) is a powerful tool to rule out coronary artery disease (CAD). In the last decade, myocardial perfusion CT (CTP) technique has been developed for the evaluation of myocardial ischemia, thereby increasing positive predictive value for diagnosis of obstructive CAD. A diagnostic strategy combining CCTA and perfusion acquisitions provides both anatomical coronary evaluation and functional evaluation of the stenosis, increasing the specificity and the positive predictive value of cardiac CT. This could improve risk stratification and guide revascularization procedures, reducing unnecessary diagnostic procedures in invasive coronary angiography. Two different acquisitions protocol have been developed for CTP. Static CTP allows a qualitative or semiquantitative evaluation of myocardial perfusion using a single scan during the first pass of iodinated contrast material in the myocardium. Dynamic CTP is capable of a quantitative evaluation of perfusion through multiple acquisitions, providing direct measure of the myocardial blood flow. For both, CTP acquisition hyperemia is reached using stressor agents such as adenosine or regadenoson. CTP in addition to CCTA acquisition shows good diagnostic accuracy compared to invasive fractional flow reserve (FFR). Furthermore, the evaluation of late iodine enhancement (LIE) could be performed allowing the detection of myocardial infarction.

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Titel: State of the art of CT myocardial perfusion
verfasst von: Giuseppe Muscogiuri
Pierpaolo Palumbo
Kakuya Kitagawa
Satoshi Nakamura
Alberto Senatieri
Carlo Nicola De Cecco
Gabrielle Gershon
Gregorio Chierchia
Jessica Usai
Daniele Sferratore
Tommaso D’Angelo
Marco Guglielmo
Serena Dell’Aversana
Sonja Jankovic
Rodrigo Salgado
Luca Saba
Riccardo Cau
Paolo Marra
Ernesto Di Cesare
Sandro Sironi
Publikationsdatum: 20.12.2024
Verlag: Springer Milan
Erschienen in: La radiologia medica / Ausgabe 3/2025
Print ISSN: 0033-8362
Elektronische ISSN: 1826-6983
DOI: https://doi.org/10.1007/s11547-024-01942-4

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State of the art of CT myocardial perfusion

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