Coronary CT Angiography: State of the Art
Technical advancements in computed tomography have provided the basis for safe, rapid, noninvasive detection of coronary artery disease with high diagnostic accuracy. While there are well-established limitations in the pure anatomic assessment of coronary
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Contents
Abstract
1 1.1 1.2 1.3
Introduction.......................................................................... Basis for Anatomic Imaging of the Coronary Arteries ....... Limitations ............................................................................. Current Use of Anatomic Data from cCTA.........................
4 4 5 6
2 2.1 2.2 2.3
Technique.............................................................................. Patient Selection and Preparation ......................................... Dataset Acquisition ............................................................... Image Reconstruction and Interpretation..............................
7 7 7 8
3 3.1 3.2 3.3
cCTA in Stable Patients withSuspected CAD.................. Diagnostic Accuracy ............................................................. Prognostic Value.................................................................... Outcomes and Costs ..............................................................
9 10 10 11
4 cCTA in Patients with Acute Chest Pain ......................... 4.1 Diagnostic Accuracy and Prognostic Value ......................... 4.2 Outcomes and Costs ..............................................................
11 12 12
Other Indications ................................................................. Evaluation of Patients with New Heart Failure ................... Patients Prior to NoncoronaryCardiac Surgery .................... Patients with Coronary Artery Stents ................................... Patients with Prior CABG.....................................................
12 12 13 13 13
6 Emerging Applications........................................................ 6.1 Detailed Plaque Analysis ...................................................... 6.2 Asymptomatic Patients..........................................................
14 14 16
7
Incidental Findings ..............................................................
16
8
Radiation Dose .....................................................................
17
9
Conclusion ............................................................................
17
References......................................................................................
17
5 5.1 5.2 5.3 5.4
Technical advancements in computed tomography have provided the basis for safe, rapid, noninvasive detection of coronary artery disease with high diagnostic accuracy. While there are well-established limitations in the pure anatomic assessment of coronary atherosclerosis, there is a growing body of data demonstrating that coronary computed tomography angiography provides valuable prognostic information and may have outcome and cost benefits over traditional diagnostic testing in selected clinical scenarios. Appropriate utilization necessitates proper technique and patient selection. The exact clinical role of computed tomography-based anatomic assessment of coronary artery disease is still evolving, and emerging techniques are encouraging for improved per
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