Computertomographie bei Patienten mit stabiler Angina Pectoris

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• 作者：M. Renker ; U. J. Schoepf ; T. Becher ; N. Krampulz ; W. Kim ; A. Rolf ; H. Möllmann…
• 关键词：SchlüsselwörterAngiographie ; Koronare Herzerkrankung ; Myokardiale CT ; Perfusion ; Koronarstenose ; Tomographie
• 刊名：Herz
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：42
• 期：1
• 页码：51-57
• 全文大小：
• 刊物类别：Medicine
• 刊物主题：Cardiology; Internal Medicine;
• 出版者：Springer Medizin
• ISSN：1615-6692
• 卷排序：42

文摘

Coronary computed tomography angiography (cCTA) has been established for the non-invasive diagnosis of coronary artery disease (CAD). Previous studies demonstrated the high diagnostic accuracy of cCTA, particularly for ruling out CAD. As a known limitation of cCTA a large number of visually significant coronary stenoses are found to be hemodynamically not relevant by invasive fractional flow reserve (FFR). CT-based FFR (CT-FFR) builds on recent advances in computational fluid dynamics and image simulation techniques. Along with CT myocardial perfusion imaging, CT-FFR is a promising approach towards a more accurate estimation of the hemodynamic relevance of coronary artery stenoses. CT-FFR is derived from regular CT datasets without additional image acquisitions, contrast material, or medication. Two CT-FFR techniques can be differentiated. The initial method requires external use of supercomputers and has gained approval for clinical use in the USA. Furthermore, a prototype-software has been introduced which is less computationally demanding via integration of reduced-order models for on-site calculation of CT-FFR. The present article reviews these methods in the context of available study results and meta-analyses. Furthermore, limitations and future concepts of CT-FFR are discussed.