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Myocardial Perfusion

  • Markus Weininger
  • U. Joseph Schoepf
  • Doo Kyoung Kang
  • Thomas Henzler
  • Balasz Ruzsics
Chapter
Part of the Medical Radiology book series (MEDRAD)

Abstract

Myocardial perfusion is an important prognostic marker in the management of patients with suspected coronary artery disease as it demonstrates the hemodynamic consequences of coronary artery stenosis. The traditional diagnostic algorithm is based on a combination of physiological and anatomical testing using different modalities. Physiological testing, such as nuclear imaging, has been extensively validated for determining the effect of stenoses on the myocardial perfusion but provides only limited anatomical information. Conversely, anatomical testing, such as invasive coronary angiography, can directly visualize and grade coronary artery stenosis but has limitations for gauging their hemodynamic effect on the myocardial perfusion.

Accordingly, a single test allowing the comprehensive evaluation of all aspects of coronary artery disease is clinically desirable. There is early evidence that cardiac computed tomography (CT) performed in single- or dual-energy mode has the potential for an integrative evaluation of both, coronary artery anatomy as well as changes in the myocardial blood supply. Cardiac dual-energy CT is based on the more recent technology of dual-source CT, and exploits the fact that iodine-based contrast medium has unique spectral characteristics when penetrated with different X-ray energy levels, enabling mapping of the iodine (and thus blood) distribution within the myocardium.

This chapter provides an overview about the role and current state of dual-energy CT in the evaluation of the myocardial perfusion.

Keywords

Single Photon Emission Compute Tomography Myocardial Perfusion Myocardial Perfusion Imaging Coronary Artery Stenosis Invasive Coronary Angiography 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2011

Authors and Affiliations

  • Markus Weininger
    • 1
  • U. Joseph Schoepf
    • 1
    • 2
  • Doo Kyoung Kang
    • 3
  • Thomas Henzler
    • 1
    • 4
  • Balasz Ruzsics
    • 1
  1. 1.Department of Radiology and Radiological ScienceMedical University of South CarolinaCharlestonUSA
  2. 2.Department of Medicine, Division of CardiologyMedical University of South CarolinaCharlestonUSA
  3. 3.Department of RadiologyAjou University HospitalSuwonSouth Korea
  4. 4.Department of Clinical Radiology and Nuclear MedicineUniversity Medical Center Mannheim, Medical Faculty Mannheim of the University of HeidelbergMannheimGermany

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