Clinical and technical considerations for stress myocardial perfusion imaging with multidetector computed tomography

Cardiovascular compute tomography (CT) is now a robust tool for the evaluation of coronary artery atherosclerosis and stenosis. A number of single-center studies, and now multicenter trials, have shown that the diagnostic accuracy of this tool compares favorably with the reference standard of conventional coronary angiography. Of course, CT angiography does not allow for the assessment of the functional significance of a given coronary lesion. However, recent reports have shown that myocardial perfusion imaging is possible with CT, opening up the possibility of providing a comprehensive evaluation of both coronary anatomy and physiology with one examination. This article reviews the principles, technical considerations, and the potential of stress myocardial perfusion imaging with CT.