Learning objectives
Non-invasive prediction of myocardial ischemia has been important issue to determine whether revascularization therapy performs or not in patient with stable coronary artery disease.Quantitative coronary CT angiography,
myocardial CT perfusion,
and CT-based fractional flow reserve (FFR) are emerging noninvasive methods for evaluation of myocardial ischemia.In this exhibition,
we will present current status,
analysis methods,
and pitfalls of each technique using various cases.
Conventional CT angiography has limited specificity and PPV for predictingfunctionally significantcoronary stenosis.
The emerging methods,
quantitative CT angiography,
CT perfusion,
and CT-FFR provide...
Background
1.
Importance of Ischemia-guided Revascularization
Quantitative assessment of coronary stenosis that revealing significant stenosis is important,
and it proved to improve the overall patients’ survival (1,
2).
Therefore,
the detection of “hemodynamically” significant stenosis is the key point when we encounter the coronary CT angiography (CTA) for the patients with suspected coronary artery disease.We are expecting the functional assessment techniques,
quantitative CTA,
CT perfusion (CTP),
and CT-derived fractional flow reserve (CT-FFR),
will overcome the limitation of visual assessment (Fig 1).
2.
Quantitative CTA
Plaque Volume...
Findings and procedure details
As a ‘one-stop shop’ for evaluation of heart,
presence of coronary artery stenosis,
plaque quantification,
ventricular function,
myocardial ischemia,
structural abnormality including valves could be assessed using CT.
Especially the emerging methods,
quantitative CT angiography,
CT perfusion,
and CT-FFR provide high diagnostic accuracy for the diagnosis of hemodynamically significant coronary stenosis.
Conclusion
During the recent years,
coronary CT has shown reliable functional information based on the three emerging techniques,
including quantitative CT angiography,
myocardial perfusion CT,
and CT-fractional flow reserve (FFR).To know how to perform each method and what are the pros and cons of the methods will help to improve the diagnostic performance.
Personal information
Disclosures of Conflicts of Interest: none
References
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Transluminal...