CT Coronary Angiography Fractional Flow Reserve: New Advances in the Diagnosis and Treatment of Coronary Artery Disease.

Autor: Shah NR; University Hospitals Cleveland Medical Center/Case Western Reserve University, Department of Radiology, Cleveland, OH. Electronic address: nrs44@case.edu., Pierce JD; University Hospitals Cleveland Medical Center/Case Western Reserve University, Department of Radiology, Cleveland, OH., Kikano EG; University Hospitals Cleveland Medical Center/Case Western Reserve University, Department of Radiology, Cleveland, OH., Rahnemai-Azar AA; University Hospitals Cleveland Medical Center/Case Western Reserve University, Department of Radiology, Cleveland, OH., Gilkeson RC; University Hospitals Cleveland Medical Center/Case Western Reserve University, Department of Radiology, Cleveland, OH., Gupta A; University Hospitals Cleveland Medical Center/Case Western Reserve University, Department of Radiology, Cleveland, OH.
Jazyk: angličtina
Zdroj: Current problems in diagnostic radiology [Curr Probl Diagn Radiol] 2021 Nov-Dec; Vol. 50 (6), pp. 925-936. Date of Electronic Publication: 2020 Sep 24.
DOI: 10.1067/j.cpradiol.2020.09.006
Abstrakt: Coronary artery disease (CAD) remains the most common cardiovascular disease, accounting for 6% of all Emergency Department visits and 27% of all Emergency Department hospitalizations. 1 Invasive coronary angiography with fractional flow reserve (FFR) remains the gold standard to assess for hemodynamically stenosis in CAD patients. However, for low- and intermediate-risk patients, noninvasive modalities have started to gain favor as patients with stable CAD who received optimal medical therapy did as well as patients who underwent percutaneous coronary intervention. 2 This led to the incorporation of FFR CT . cCTA provides good spatial resolution for evaluating stenosis. FFR provides additional information regarding whether the stenosis is hemodynamically significant. FFR is the ratio of maximum blood flow in a stenotic artery to the maximum blood flow through that artery without stenosis. 3 Computational fluid dynamics involved in FFR CT is based on Navier-Stokes equations, allowing the assessment of pressure and flow across coronary arteries. Limitations do exist with FFR CT which includes false-positive results due to step artifact and left ventricular hypertrophy, as well as manual segmentation and ostial stenosis, which can cause false-negative results. However, there are improvements on the horizon including artificial intelligence-driven computation of FFR and the utilization of virtual stenting for surgical planning. The purpose of this review is to describe the clinical validation, underlying mechanism, and implementation of FFR CT .
(Copyright © 2020 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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