CT of coronary artery disease.
The socioeconomic importance of heart disease provides considerable motivation for development of radiologic tools for noninvasive imaging of the coronary arteries. Current computed tomographic (CT) techniques combine high speed and spatial resolution with sophisticated electrocardiographic synchronization and robustness of use. Application of these modalities for evaluation of coronary artery disease is a topic of active current research. Coronary artery calcium measurements with different CT techniques have been used for determining the risk of coronary events, but the exact role of this marker for cardiac risk stratification remains unclear pending results of population-based studies. Contrast material-enhanced CT coronary angiography has become an established clinical indication for some scenarios (eg, coronary artery anomalies, bypass patency, surgical planning). With current technology, the accuracy of CT coronary angiography for detection of coronary artery stenoses appears promising enough to warrant pursuit of this application, but sensitivity is still not high enough for routine diagnostic needs. The high negative predictive value of a normal CT coronary angiogram, however, may be useful for reliable exclusion of coronary artery stenosis. The cross-sectional nature of CT may allow noninvasive assessment of the coronary artery wall. Use of contrast-enhanced CT coronary angiography for detection, characterization, and quantification of atherosclerotic changes and total disease burden in coronary arteries as a potential tool for cardiac risk stratification is currently being investigated.
Schoepf
U Joseph
UJ
Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA. schoepf@bwh.harvard.edu
Becker
Christoph R
CR
Ohnesorge
Bernd M
BM
Yucel
E Kent
EK
D002114:Calcinosis / Q000000981:diagnostic imaging; D003287:Contrast Media / Q000008:administration & dosage; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D004562:Electrocardiography; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D011829:Radiation Dosage; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods
D003287:Contrast Media