Potential of myocardial perfusion and viability studies

Abstract

Coronary artery disease (CAD) is among the leading causes of death within developed countries. Multislice CT has already been evaluated within the last 5 years regarding its ability to assess the coronary artery tree and coronary artery stenosis. In these evaluations, coronary artery CTA was used to show cardiac and coronary morphology as well as pathologic changes. The topic of coronary artery CTA is highlighted and explored in other chapters. The coronary artery wall undergoes pathologic changes in which plaques develop, subsequently causing luminal narrowing and thus impaired blood supply of the downstream myocardium. Imaging of these changes in myocardial blood flow and therefore myocardial perfusion is the focus of perfusion imaging techniques by different approaches. For example, nuclear medicine techniques, such as SPECT and positron emission tomography (PET), are clinically used for the assessment of myocardial perfusion in the diagnosis of CAD. Within the last decade, also MRI techniques have been applied to assess myocardial perfusion using first-pass techniques. The pharmacological and physiological principles of perfusion imaging in MRI and CT are basically the same. EBCT has already shown that perfusion studies can also be carried out using a multi-slice CT scanning technique. © 2007 Springer-Verlag Berlin Heidelberg.