Myocardial Perfusion Assessment by 3D and 4D Computed Tomography

Quantification of myocardial perfusion is the holy grail of cardiovascular imaging. Computed tomography angiography (CTA) is the most accurate noninvasive diagnostic test to diagnose obstructive coronary artery disease (CAD) but lacks the ability to quantify the functional relevance of coronary artery stenosis. Using myocardial CT perfusion might enable comprehensive assessment of coronary artery disease by quantification of myocardial blood flow (MBF). The rather high radiation dose and the complicated analysis of 4D CT are the main challenges for achieving this goal. This chapter summarises the present status of myocardial perfusion imaging and describes potential technical and clinical solutions for myocardial perfusion assessment by CT.