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Abstract
Over the last years a dramatic improvement in multidetector CT technology has occurred. The ability to noninvasively image the coronary artery lumen and wall and obtain information on the presence, severity, and characteristics of coronary artery disease , including the visualization of luminal obstruction and atherosclerosis , constitutes an attractive addition to currently available diagnostic tools, such as nuclear perfusion imaging or invasive selective coronary angiography, for the work-up of patients with known or suspected coronary artery disease.
Advances in multidetector CT technology with submillimeter slice collimation and high temporal resolution permit contrast-enhanced imaging of coronary arteries and coronary plaque during a single breath hold. Appropriate patient preparation, detailed technical and technological knowledge with regard to recognition of typical imaging artifacts (such as beam hardening or motion artifacts), and the adequate choice of postprocessing techniques to detect stenosis and plaque are prerequisites to achieving diagnostic image quality.
Multi-slice coronary CT angiography is highly accurate for the exclusion of significant coronary artery stenosis (>50% luminal narrowing), with negative predictive values, in comparison with invasive selective coronary angiography.