Centro Cardiologico Monzino, IRCCS, Milan, Italy.
Sapienza University, Policlinico Umberto I, Rome, Italy.
J Cardiovasc Comput Tomogr. 2020 Jul-Aug;14(4):294-302. doi: 10.1016/j.jcct.2019.09.002. Epub 2019 Sep 12.
Large multicenter studies and meta-analysis have documented the diagnostic accuracy and the prognostic implications of stress echocardiography, cardiac magnetic resonance and, mainly, nuclear stress tests. However, none of them provides a comprehensive anatomical and functional evaluation within the same study as stress CT perfusion. Myocardial CT perfusion is the only non-invasive modality that allows to quantifying coronary stenosis and determining its functional relevance, constituting a potential "one-stop-shop" method for the diagnosis and global management of patients with known or suspected coronary artery disease. In comparison with the dynamic modality, that requires increased radiation, precise acquisition protocols and dedicated post-processing softwares, static CT perfusion was associated with less radiation exposure, non-inferior diagnostic accuracy, easier interpretation of images and is nowadays more widely available.
大型多中心研究和荟萃分析已经证明了应激超声心动图、心脏磁共振以及主要的核应激试验的诊断准确性和预后意义。然而,它们都没有像应激 CT 灌注那样在同一个研究中提供全面的解剖和功能评估。心肌 CT 灌注是唯一允许定量冠状动脉狭窄并确定其功能相关性的非侵入性方式,为已知或疑似冠心病患者的诊断和整体管理提供了一种潜在的“一站式”方法。与需要增加辐射、精确采集方案和专用后处理软件的动态模式相比,静态 CT 灌注的辐射暴露较少,诊断准确性相当,图像解读更简单,并且现在更为广泛应用。