title: Taekling the challenges of interpretation of conventional coronary angiography using multidetector CT coronary angiography.
abstract: BACKGROUND
  Although conventional catheter angiography is still regarded as the gold standard for anatomical visualisation of the coronary artery tree, it faces a number of challenges and pitfalls concerning the interpretation of the acquired images.
  
  
  OBJECTIVE
  The aim of this review is to demonstrate that multidetector computed tomography (MDCT) can provide information that is not or only partially acquired by coronary angiography (CAG).
  
  
  METHODS
  For different interpretation issues and pitfalls, we establish whether MDCT can provide better, i.e. more standardised and reproducible, information on the basis of both the properties of the technique and clinical examples.
  
  
  RESULTS
  Advantages of MDCT are full three- and four-dimensional coverage of the heart and contrast enhancement of all vascular compartments together with a superior low contrast resolution. MDCT shortcomings are the low temporal resolution and related to this the lack of flow information compared with catheter coronary angiography. MDCT is shown to meet most of the blind spots and pitfalls described for catheter coronary angiography.
  
  
  CONCLUSIONS
  Cardiac and coronary MDCT provides diagnostic information, which equals CAG diagnosis in most cases, and in some cases even provides a better diagnosis. This could influence the value of the sensitivity and specificity numbers published comparing noninvasive techniques with catheter coronary angiography (gold standard). Due to the added advantages of CT and its continuous improvement of temporal and spatial resolution, it might eventually replace diagnostic catheter coronary angiography.
authors.forename: P M A
authors.initials: PM
authors.lastname: van Ooijen
authors.forename: J
authors.initials: J
authors.lastname: Dorgelo
authors.forename: F
authors.initials: F
authors.lastname: Zijlstra
authors.forename: M
authors.initials: M
authors.lastname: Oudkerk
keywords: coronary angiography; coronary artery disease; multidetector computed tomography