Beyond stenosis detection: computed tomography approaches for determining the functional relevance of coronary artery disease

Abstract

Coronary computed tomography angiography (CCTA) is an established imaging technique for the noninvasive assessment of coronary arteries. However, CCTA remains a morphologic technique with the same limitations as invasive coronary angiography in evaluating the hemodynamic significance of coronary stenosis. Different computed tomography (CT) techniques for the functional analysis of coronary lesions have recently emerged, including static and dynamic CT myocardial perfusion imaging and CT-based fractional flow reserve and transluminal attenuation gradient methods. These techniques hold promise for achieving a comprehensive appraisal of anatomic and functional aspects of coronary heart disease with a single modality.

Keywords: Coronary CT angiography; Coronary artery disease; Dual-energy CT; Fractional flow reserve; Myocardial perfusion imaging; Transluminal attenuation gradient.