Coronary CT angiography: Beyond morphological stenosis analysis

Abstract

Rapid technological developments in computed tomography (CT) imaging technique have made coronary CT angiography an attractive imaging tool in the detection of coronary artery disease. Despite visualization of excellent anatomical details of the coronary lumen changes, coronary CT angiography does not provide hemodynamic changes caused by presence of plaques. Computational fluid dynamics (CFD) is a widely used method in the mechanical engineering field to solve complex problems through analysing fluid flow, heat transfer and associated phenomena by using computer simulations. In recent years, CFD is increasingly used in biomedical research due to high performance hardware and software. CFD techniques have been used to study cardiovascular hemodynamics through simulation tools to assist in predicting the behaviour of circulatory blood flow inside the human body. Blood flow plays a key role in the localization and progression of coronary artery disease. CFD simulation based on 3D luminal reconstructions can be used to analyse the local flow fields and flow profiling due to changes of vascular geometry, thus, identifying risk factors for development of coronary artery disease. The purpose of this article is to provide an overview of the coronary CT-derived CFD applications in coronary artery disease.

Keywords: Computational fluid dynamics, Coronary artery disease, Hemodynamics, Modelling

Core tip: Coronary computed tomography (CT) angiography is limited to the visualization of anatomical details of coronary artery tree, while computational fluid dynamics (CFD) overcomes this limitation by providing hemodynamic changes to the coronary artery due to presence of plaques. CFD has been increasingly used in the investigation of cardiovascular disease due to its ability of providing flow changes and variations. This article provides an overview of the clinical applications of coronary CT-derived CFD in coronary artery disease.