Groenhoff Léon, De Zan Giulia, Costantini Pietro, Siani Agnese, Ostillio Eleonora, Carriero Serena, Muscogiuri Giuseppe, Bergamaschi Luca, Patti Giuseppe, Pizzi Carmine, Sironi Sandro, Pavon Anna Giulia, Carriero Alessandro, Guglielmo Marco
Radiology Department, Maggiore della Carità Hospital, 28100 Novara, Italy.
Department of Translational Medicine, University of Eastern Piedmont, Maggiore della Carità Hospital, 28100 Novara, Italy.
J Clin Med. 2023 May 31;12(11):3793. doi: 10.3390/jcm12113793.
Coronary artery disease is still a major cause of death and morbidity worldwide. In the setting of chronic coronary disease, demonstration of inducible ischemia is mandatory to address treatment. Consequently, scientific and technological efforts were made in response to the request for non-invasive diagnostic tools with better sensitivity and specificity. To date, clinicians have at their disposal a wide range of stress-imaging techniques. Among others, stress cardiac magnetic resonance (S-CMR) and computed tomography perfusion (CTP) techniques both demonstrated their diagnostic efficacy and prognostic value in clinical trials when compared to other non-invasive ischemia-assessing techniques and invasive fractional flow reserve measurement techniques. Standardized protocols for both S-CMR and CTP usually imply the administration of vasodilator agents to induce hyperemia and contrast agents to depict perfusion defects. However, both methods have their own limitations, meaning that optimizing their performance still requires a patient-tailored approach. This review focuses on the characteristics, drawbacks, and future perspectives of these two techniques.
冠状动脉疾病仍然是全球范围内死亡和发病的主要原因。在慢性冠状动脉疾病的情况下，必须证明存在可诱导的缺血才能确定治疗方案。因此，为了满足对具有更高灵敏度和特异性的非侵入性诊断工具的需求，人们在科技方面做出了努力。迄今为止，临床医生可以使用多种负荷成像技术。其中，负荷心脏磁共振成像（S-CMR）和计算机断层扫描灌注成像（CTP）技术在临床试验中与其他非侵入性缺血评估技术和侵入性血流储备分数测量技术相比，均显示出了其诊断效能和预后价值。S-CMR和CTP的标准化方案通常都需要使用血管扩张剂来诱导充血，并使用造影剂来描绘灌注缺损。然而，这两种方法都有其自身的局限性，这意味着优化它们的性能仍需要采取因人而异的方法。本综述重点关注这两种技术的特点、缺点及未来前景。
