Noninvasive Cardiovascular Imaging Program, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
Nat Rev Cardiol. 2010 Apr;7(4):226-36. doi: 10.1038/nrcardio.2010.15. Epub 2010 Mar 9.
Advances in cardiovascular imaging have resulted in the development of multiple noninvasive techniques to evaluate myocardial perfusion and coronary anatomy, each of which has unique strengths and limitations. For example, CT angiography can directly visualize the presence of atherosclerosis, but the hemodynamic effect of many lesions identified by this technique is unknown. Alternatively, myocardial perfusion imaging enables a physiological assessment, but it may underestimate the extent of atherosclerosis in patients with multivessel disease. Dual-modality simultaneous imaging or multimodal sequential imaging techniques facilitate integration of information on both myocardial perfusion and coronary anatomy, and thus have the potential to improve diagnostic and prognostic evaluation, which could translate into improved care of patients. This Review discusses the strengths and limitations of the currently available individual noninvasive techniques for imaging coronary anatomy and myocardial perfusion. Approaches to integration of these imaging modalities are described, followed by an exploration of the clinical utility and future directions of hybrid imaging.
心血管成像技术的进步催生了多种非侵入性技术，用于评估心肌灌注和冠状动脉解剖结构，每种技术都有其独特的优势和局限性。例如，CT 血管造影可以直接显示动脉粥样硬化的存在，但该技术所识别的许多病变的血流动力学效应尚不清楚。另一方面，心肌灌注成像可以进行生理学评估，但在多支血管疾病患者中可能会低估动脉粥样硬化的程度。双模态同时成像或多模态序贯成像技术有助于整合心肌灌注和冠状动脉解剖结构的信息，因此有可能改善诊断和预后评估，进而改善患者的治疗效果。本文讨论了目前用于成像冠状动脉解剖结构和心肌灌注的各种非侵入性技术的优势和局限性。接着介绍了整合这些成像方式的方法，然后探讨了混合成像的临床应用价值和未来方向。
