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Cademartiri F, Seitun S, Clemente A, et al. Myocardial blood flow quantification for evaluation of coronary artery disease by computed tomography. Cardiovasc Diagn Ther. 2017;7(2):129-150doi: 10.21037/cdt.2017.03.22.
Cademartiri, F., Seitun, S., Clemente, A., La Grutta, L., Toia, P., Runza, G., Midiri, M., & Maffei, E. (2017). Myocardial blood flow quantification for evaluation of coronary artery disease by computed tomography. Cardiovascular diagnosis and therapy, 7(2), 129-150. https://doi.org/10.21037/cdt.2017.03.22
Cademartiri, Filippo, et al. "Myocardial blood flow quantification for evaluation of coronary artery disease by computed tomography." Cardiovascular diagnosis and therapy vol. 7,2 (2017): 129-150. doi: https://doi.org/10.21037/cdt.2017.03.22
Cademartiri F, Seitun S, Clemente A, La Grutta L, Toia P, Runza G, Midiri M, Maffei E. Myocardial blood flow quantification for evaluation of coronary artery disease by computed tomography. Cardiovasc Diagn Ther. 2017 Apr;7(2):129-150. doi: 10.21037/cdt.2017.03.22. PMID: 28540209; PMCID: PMC5422837.
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Cardiovasc Diagn Ther. 2017 Apr;7(2):129-150. doi: 10.21037/cdt.2017.03.22.

Myocardial blood flow quantification for evaluation of coronary artery disease by computed tomography.

Cardiovascular diagnosis and therapy

Filippo Cademartiri, Sara Seitun, Alberto Clemente, Ludovico La Grutta, Patrizia Toia, Giuseppe Runza, Massimo Midiri, Erica Maffei

Affiliations

  1. Department of Radiology, Montreal Heart Institute, Université de Montreal, Montreal, Canada.
  2. Department of Radiology, Erasmus Medical Center University, Rotterdam, The Netherlands.
  3. Department of Radiology, IRCCS AOU San Martino-IST, Genoa, Italy.
  4. Department of Radiology, Fondazione Toscana Gabriele Monasterio, Pisa and Massa, Italy.
  5. Department of Radiology, University of Palermo, Palermo, Italy.
  6. Department of Radiology, P.O. Umberto I, Azienda Sanitaria Provinciale 8, Siracusa, Italy.

PMID: 28540209 PMCID: PMC5422837 DOI: 10.21037/cdt.2017.03.22

Abstract

During the last decade coronary computed tomography angiography (CTA) has become the preeminent non-invasive imaging modality to detect coronary artery disease (CAD) with high accuracy. However, CTA has a limited value in assessing the hemodynamic significance of a given stenosis due to a modest specificity and positive predictive value. In recent years, different CT techniques for detecting myocardial ischemia have emerged, such as CT-derived fractional flow reserve (FFR-CT), transluminal attenuation gradient (TAG), and myocardial CT perfusion (CTP) imaging. Myocardial CTP imaging can be performed with a single static scan during first pass of the contrast agent, with monoenergetic or dual-energy acquisition, or as a dynamic, time-resolved scan during stress by using coronary vasodilator agents (adenosine, dipyridamole, or regadenoson). A number of CTP techniques are available, which can assess myocardial perfusion in both a qualitative, semi-quantitative or quantitative manner. Once used primarily as research tools, these modalities are increasingly being used in routine clinical practice. All these techniques offer the substantial advantage of combining anatomical and functional evaluation of flow-limiting coronary stenosis in the same examination that would be beneficial for clinical decision-making. This review focuses on the state-of the-art and future trends of these evolving imaging modalities in the field of cardiology for the physiologic assessments of CAD.

Keywords: Cardiac computed tomography; coronary artery disease (CAD); myocardial blood flow quantification; myocardial perfusion imaging; stress imaging

Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

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