title: CT stress myocardial perfusion imaging using multidetector CT--A review.
abstract: Computed tomography coronary angiography (CTA) accurately detects and excludes coronary artery disease (CAD); however, the physiological significance of coronary artery lesions may be uncertain. CT myocardial perfusion imaging (CTP) acquired during vasodilator stress provides a novel and emerging method for detection of myocardial ischemia. Multiple studies have established the feasibility of CTP and suggested its incremental value when used in combination with CTA in the identification of hemodynamically significant stenoses as compared with CTA alone. Despite these encouraging clinical data, CT perfusion assessment is in its infancy, as further research is required to validate and optimize this new technique. Combined CTA/CTP imaging has significant potential, as it offers the convenience of assessing both coronary anatomy and myocardial perfusion in one single examination at a radiation dose equivalent to contemporary nuclear medicine imaging. In this review, we provide an overview of the fundamentals of CT perfusion imaging, recent advances in scanner types and imaging techniques and protocols, and current literature on the accuracy of CTP, concluding with its future challenges and directions.
authors.affiliation: Monash Cardiovascular Research Centre, Monash HEART, Department of Medicine, Monash Medical Centre (MMC), Southern Health and Monash University, Melbourne, 246 Clayton Road, Clayton, 3168 VIC, Australia.
authors.forename: Brian S
authors.initials: BS
authors.lastname: Ko
authors.forename: James D
authors.initials: JD
authors.lastname: Cameron
authors.forename: Tony
authors.initials: T
authors.lastname: Defrance
authors.forename: Sujith K
authors.initials: SK
authors.lastname: Seneviratne
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology; D003326:Coronary Circulation; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D011237:Predictive Value of Tests; D011379:Prognosis; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D014665:Vasodilator Agents
chemical_list: D014665:Vasodilator Agents