scholarly journals Advances in Cardiac Computed Tomography Functional Imaging Technology

Cardiology ◽  
2020 ◽  
Vol 145 (10) ◽  
pp. 615-622
Author(s):  
Xu-Wei Tian ◽  
Ai-Lin Ma ◽  
Ren-Bing Zhou ◽  
Liu-Jiang Jiang ◽  
Yue Hao ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
Functional Imaging ◽  
Cardiac Ct ◽  
Cardiac Computed Tomography ◽  
Fractional Flow ◽  
Flow Reserve ◽  
Examination Methods ◽  
Important Direction ◽  
Transluminal Attenuation Gradient

Cardiovascular disease (CVD) is the leading cause of death among patients in China, and cardiac computed tomography (CT) is one of the most commonly used examination methods for CVD. Coronary artery CT angiography can be used for the morphologic evaluation of the coronary artery. At present, cardiac CT functional imaging has become an important direction of development of CT. At present, common CT functional imaging technologies include transluminal attenuation gradient, stress dynamic CT myocardial perfusion imaging, and CT-fractional flow reserve. These three imaging modes are introduced and analyzed in this review.

scholarly journals The transluminal attenuation gradient does not add diagnostic accuracy to coronary computed tomography

2020 ◽  
pp. 028418512094304
Author(s):  
Lilian Henriksson ◽  
Mischa Woisetschläger ◽  
Joakim Alfredsson ◽  
Magnus Janzon ◽  
Tino Ebbers ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
Roc Analysis ◽  
Ct Perfusion ◽  
Coronary Vessels ◽  
Fractional Flow ◽  
Coronary Computed Tomography ◽  
Flow Reserve ◽  
Incremental Value ◽  
Transluminal Attenuation Gradient

Background A method for improving the accuracy of coronary computed tomography angiography (CCTA) is highly sought after as it would help to avoid unnecessary invasive coronary angiographies. Measurement of the transluminal attenuation gradient (TAG) has been proposed as an alternative to other existing methods, i.e. CT perfusion and CT fractional flow reserve (FFR). Purpose To evaluate the incremental value of three types of TAG in high-pitch spiral CCTA with invasive FFR measurements as reference. Material and Methods TAG was measured using two semi-automatic methods and one manual method. A receiver operating characteristic (ROC) analysis was made to determine the usefulness of TAG alone as well as TAG combined with CCTA for detection of significant coronary artery stenoses defined by an invasive FFR value ≤0.80. Results A total of 51 coronary vessels in 37 patients were included in this retrospective study. Hemodynamically significant stenoses were found in 13 vessels according to FFR. The ROC analysis TAG alone resulted in areas under the curve (AUCs) of 0.530 and 0.520 for the semi-automatic TAG and 0.557 for the manual TAG. TAG and CCTA combined resulted in AUCs of 0.567, 0.562 for semi-automatic TAG, and 0.569 for the manual TAG. Conclusion The results from our study showed no incremental value of TAG measured in single heartbeat CCTA in determining the severity of coronary artery stenosis degrees.

scholarly journals Cardiac Computed Tomography – More Than Coronary Arteries? A Clinical Update

2019 ◽  
Vol 191 (09) ◽  
pp. 817-826
Author(s):  
Jana Taron ◽  
Borek Foldyna ◽  
Parastou Eslami ◽  
Udo Hoffmann ◽  
Konstantin Nikolaou ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cardiac Ct ◽  
Cardiac Computed Tomography ◽  
Preoperative Imaging ◽  
Special Focus ◽  
Fractional Flow ◽  
Rapid Improvement ◽  
Coronary Ct ◽  
Flow Reserve ◽  
Artery Disease

Background Rapid improvement of scanner and postprocessing technology as well as the introduction of minimally invasive procedures requiring preoperative imaging have led to the broad utilization of cardiac computed tomography (CT) beyond coronary CT angiography (CTA). Method This review article presents an overview of recent literature on cardiac CT. The goal is to summarize the current guidelines on performing cardiac CT and to list established as well as emerging techniques with a special focus on extracoronary applications. Results and Conclusion Most recent guidelines for the appropriate use of cardiac CT include the evaluation of coronary artery disease, cardiac morphology, intra- and extracardiac structures, and functional and structural assessment of the myocardium under certain conditions. Besides coronary CTA, novel applications such as the calculation of a CT-derived fractional flow reserve (CT-FFR), assessment of myocardial function and perfusion imaging, as well as pre-interventional planning in valvular heart disease or prior pulmonary vein ablation in atrial fibrillation are becoming increasingly important. Especially these extracoronary applications are of growing interest in the field of cardiac CT and are expected to be gradually implemented in the daily clinical routine. Key Points:  Citation Format

scholarly journals Physiological Evaluation of Anomalous Aortic Origin of a Coronary Artery Using Computed Tomography–Derived Fractional Flow Reserve

2021 ◽  
Author(s):  
Julien Adjedj ◽  
Fabien Hyafil ◽  
Xavier Halna du Fretay ◽  
Patrick Dupouy ◽  
Jean‐Michel Juliard ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
Ct Angiography ◽  
Fractional Flow Reserve ◽  
Coronary Ct Angiography ◽  
Functional Evaluation ◽  
Fractional Flow ◽  
Coronary Ct ◽  
Flow Reserve

Background With the emergence of coronary computed tomography (CT) angiography, anomalous aortic origin of a coronary artery (ANOCOR) is more frequently diagnosed. Fractional flow reserve derived from CT (FFRCT) is a noninvasive functional test providing anatomical and functional evaluation of the overall coronary tree. These unique features of anatomical and functional evaluation derived from CT could help for the management of patients with ANOCOR. We aimed to retrospectively evaluate the physiological and clinical impact of FFRCT analysis in the ANOCOR registry population. Methods and Results The ANOCOR registry included patients with ANOCOR detected during invasive coronary angiography or coronary CT angiography between January 2010 and January 2013, with a planned 5‐year follow‐up. We retrospectively performed FFRCT analysis in patients with coronary CT angiography of adequate quality. Follow‐up was performed with a clinical composite end point (cardiac death, myocardial infarction, and unplanned revascularization). We obtained successful FFRCT analyses and 5‐year clinical follow‐up in 54 patients (average age, 60±13 years). Thirty‐eight (70%) patients had conservative treatment, and 16 (30%) patients had coronary revascularization after coronary CT angiography. The presence of an ANOCOR course was associated with a moderate reduction of FFRCT value from 1.0 at the ostium to 0.90±0.10 downstream the ectopic course and 0.82±0.11 distally. No significant difference in FFRCT values was identified between at‐risk and not at‐risk ANOCOR. After a 5‐year follow‐up, only one unplanned percutaneous revascularization was reported. Conclusions The presence of ANOCOR was associated with a moderate hemodynamic decrease of FFRCT values and associated with a low risk of cardiovascular events after a 5‐year follow‐up in this middle‐aged population.

scholarly journals Left Main Coronary Artery Thrombus Diagnosed and Managed With Coronary Computed Tomography Angiography and Fractional Flow Reserve Derived From Computed Tomography

2019 ◽  
Vol 13 ◽  
pp. 117954681989459
Author(s):  
Shone O Almeida ◽  
Nasih M Ahmed ◽  
Ronald P Karlsberg
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
Fractional Flow Reserve ◽  
Computed Tomography Angiography ◽  
Left Main Coronary Artery ◽  
Coronary Computed Tomography Angiography ◽  
Left Main ◽  
Fractional Flow ◽  
Coronary Cta ◽  
Flow Reserve

Left main coronary artery thrombus (LMCA-T) is a rare disease state and diagnosed with invasive coronary angiography (ICA). We present a case of LMCA-T diagnosed with coronary computed tomography angiography (CTA) and treated without ICA in a patient who presented to a hospital in the middle of war zone in Erbil, Iraqi Kurdistan. Coronary CTA performed 1 month later demonstrated resolution of the thrombus. Fractional flow reserve computed from computed tomography (FFR-CT; HeartFlow, Redwood City, CA) performed retrospectively confirmed that the clot was not hemodynamically significant at the time of diagnosis. This case demonstrates the diagnostic capabilities of coronary CTA and FFR-CT when ICA is not readily available.

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