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Review
. 2016 Nov 15;8(11):4523-4531.
eCollection 2016.

Advances in myocardial CT perfusion imaging technology

Affiliations
Review

Advances in myocardial CT perfusion imaging technology

Yan Yi et al. Am J Transl Res. .

Abstract

With the booming development of CT technology, CT-based myocardial perfusion imaging (CTP) has begun to mature and has exhibited great advantages and application prospects as a complete evaluation method of anatomy and function for CAD. This article summarizes the CTP technology progress and analytical methods of CTP in recent years, briefly reviews the clinical relevance, and subsequently discusses the limitation and future development.

Keywords: Coronary artery disease; X-ray computed; myocardial ischemia; myocardial perfusion imaging; tomography.

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Figures

Figure 1
Figure 1
Progress of CTP studies. Over the past few years, CT technology has rapidly developed; scanning modes have evolved from a single spectrum CT to dual-source and dual-energy CTs, and the widths of the detectors have evolved from 4-detector row systems to 64-detector and (more recently) 320-detector systems. The corresponding temporal and spatial resolutions have been greatly improved, and the radiation dose has been significantly reduced.
Figure 2
Figure 2
A 43-year-old woman with hypertension and atypical chest pain. (A) Visual assessment of a stress CT perfusion axial image reveals a low-density area in the interventricular septum and the left ventricular anterior wall (black triangle arrows). (B, C) A maximum intensity projection (MIP, B) and volume rendering (VR, C) of a CT angiograph reveals shows significant stenosis (white arrow) in the mid-left anterior descending coronary artery. (D-H) All of the quantitative parameters, including the MBF (D), MBV (E), TTP (F), TTT (G) and local hemodynamic absolute numbers (H) demonstrate the anterior perfusion defect (1 and 2) compared with a normal myocardium (3). (I) ROI-TAC of a normal myocardium (3).
Figure 3
Figure 3
A 65-year-old man with chest tightness. (A, B) Volume rendering (VR, A) and maximum intensity projection (MIP, B) of a CT angiograph revealing significant stenosis (white triangle and white arrow) in the distal segment of right coronary artery (RCA) at the bottom of the left ventricle. (C) Significant stenosis in the distal segment of the RCA (white arrow) confirmed by coronary angiography (CAG, C). (D-F) MBF (D, E) of a stress CTP showing no perfusion decrease in the interventricular septum myocardium or the inferior myocardium of the left ventricle. The local hemodynamic absolute number (H) and TAC are normal. Within 2-5 years of follow-up, this patient had no major adverse cardiovascular events (MACE), including cardiac death, non-fatal myocardial infarction (MI), unstable angina (UA), or revascularization.

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