Fractional Flow Reserve derived from CT (FFRct) has rapidly progressed and is being used clinically in a lot of several different countries. It is based on standard CCTA imaging and utilizes heart rate control with B-Blockers and sublingual nitroglycerin to achieve hyperemia. It is more precise as compared to CCTA for identifying narrowing in heavily calcified coronary arteries. FFRCT may be particularly useful to adjudicate intermediate stenosis found on CCTA. The technique developed is currently the only FDA and CE Mark-cleared FFRCT technology.
In short, a 3D (three-dimensional) model of the epicardial coronary arteries, aorta, and myocardium is created. Machine learning techniques aid in creating a mesh of the coronary lumen with subvoxel precision. These same machine learning techniques allow for interpretation of the lumen for 3D anatomic modeling in calcified vessels that is superior to that of the human eye. For each vessel supplying the myocardium, resting and hyperemic microvascular resistance are quantified by the 3D anatomic and microvascular resistance models.
While some technologies utilize computational fluid dynamics with thousands of assumptions, others are able to derive it more directly based on plaque morphology, allowing physicians to understand how the value was generated. A color-coded, 3D anatomic model with FFRCT values available in every location of the coronary tree is generated. A simple point and click tool can then be drawn on to display FFRCT values in the desired location. When the FFRCT value is combined with the patient-specific anatomic coronary map, functionality significant lesions can be denied.
Intraplaque Hemorrhage
HRMRI (High-resolution magnetic resonance imaging) is ideal for serial examination of diseased arterial walls for the reason that it is non-invasive and has a superior capability of discriminating tissue characteristics. The aim of the study is to evaluate the prevalence and clinical relevance of intraplaque hemorrhage (IPH) in patients with basilar artery (BA) atherosclerosis with the help of HRMRI.
The medical experts analyzed HRMRI and clinical data from 74 patients (45 symptomatic and 29 asymptomatic), all of whom had >50% BA stenosis. High-signal intensity within a BA plaque on the magnetization-prepared rapid acquisition with gradient-echo was defined as an area with an intensity that was >150% of the signal from the adjacent muscle. The relationship between IPH within a BA plaque region and clinical presentation was analyzed.
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