Accurate evaluation of myocardial ischaemia is critical for the management of coronary artery disease (CAD). Quantitative perfusion cardiovascular magnetic resonance (QP-CMR) provides high-resolution assessment of absolute myocardial blood flow (MBF) without ionising radiation. It has demonstrated excellent diagnostic performance for detecting haemodynamically significant CAD, often outperforming visual analysis, particularly in the setting of multi-vessel disease. Similarly, quantitative computed tomography perfusion (CTP) integrates coronary anatomy with functional data and has been shown to significantly improve diagnostic accuracy and specificity over coronary CT angiography alone. This review provides an overview of quantitative myocardial perfusion imaging using CMR and cardiac CT, including their fundamental principles and diagnostic performance. Furthermore, we explore their expanding clinical applications beyond epicardial CAD, such as the evaluation of coronary microvascular dysfunction and non-ischaemic cardiomyopathies, and discuss their advantages and limitations as well as future directions.
Nakamura et al. (Fri,) studied this question.