title: Noninvasive fractional flow reserve derived from coronary computed tomography angiography: integrated anatomical and functional assessment.
abstract: Coronary computed tomographic angiography (CCTA) provides anatomic detail of lumen stenosis and information on plaque burden, plaque extent and plaque characteristics. CCTA does not, however, provide insight into the hemodynamic significance of a stenosis, which is essential to allow appropriate revascularization decision-making. This could reduce downstream invasive coronary angiography and nonbeneficial coronary revascularization, particularly with intermediate coronary stenosis. Invasive fractional flow reserve (FFR) is the gold standard for the determination of lesion-specific ischemia and the need for revascularization. Advances in computational technology now permit calculation of FFR using resting CCTA image data, without the need for additional radiation or medication. Early data demonstrate improved accuracy and a discriminatory ability of FFR computed tomography to identify ischemia-producing lesions compared with CCTA alone. This new, combined anatomic-functional assessment has the potential to simplify the noninvasive diagnosis of coronary artery disease with a single study to identify patients with ischemia-causing stenosis who may benefit from revascularization.
authors: Department of Diagnostic Radiology, King Fahd Military Medical Complex, Dhahran 31932, Kingdom of Saudi Arabia.
authors: Donya
authors: D
authors: Al-Hassan
authors: Jonathon
authors: J
authors: Leipsic
mesh_terms: D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000503:physiopathology*; D023921:Coronary Stenosis / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D053805:Fractional Flow Reserve, Myocardial / Q000502:physiology; D006801:Humans; D057446:Hydrodynamics; D007091:Image Processing, Computer-Assisted; D008953:Models, Anatomic; D008955:Models, Cardiovascular; D017202:Myocardial Ischemia / Q000209:etiology / Q000503:physiopathology; D009204:Myocardial Revascularization; D012680:Sensitivity and Specificity