Branch Kelley R, Haley Ryan D, Bittencourt Marcio Sommer, Patel Amit R, Hulten Edward, Blankstein Ron
Department of Medicine (Cardiovascular Division), University of Washington, Seattle, WA, USA.
Cardiology Service, Department of Internal Medicine, Walter Reed National Military Medical Center, Bethesda, MD, USA.
Cardiovasc Diagn Ther. 2017 Oct;7(5):452-462. doi: 10.21037/cdt.2017.06.11.
Despite having excellent diagnostic accuracy to detect anatomical coronary stenosis, coronary CT angiography (CTA) has a limited specificity to detect myocardial ischemia. CT perfusion (CTP) can identify myocardial perfusion defects during vasodilator stress, and when added to coronary CTA, improves the specificity of detecting hemodynamically significant stenosis. A CTP protocol typically involves the acquisition of two separate data sets: (I) a rest scan that can be used as both a coronary CTA and for evaluating rest myocardial perfusion, and (II) a stress CTP scan acquired during vasodilator stress testing. This review summarizes some the techniques, strengths, and limitations of CTP, and provides an overview of the recent evidence supporting the potential use of CTP in clinical practice.
尽管冠状动脉CT血管造影（CTA）在检测解剖学冠状动脉狭窄方面具有出色的诊断准确性，但在检测心肌缺血方面特异性有限。CT灌注（CTP）可以在血管扩张剂负荷试验期间识别心肌灌注缺损，并且与冠状动脉CTA相结合时，可提高检测具有血流动力学意义狭窄的特异性。CTP方案通常包括采集两个单独的数据集：（I）静息扫描，可同时用作冠状动脉CTA和评估静息心肌灌注，以及（II）在血管扩张剂负荷试验期间采集的负荷CTP扫描。本综述总结了CTP的一些技术、优势和局限性，并概述了支持CTP在临床实践中潜在应用的最新证据。
