Multislice CT Coronary Angiography in Evaluation of Coronary Artery Disease

The investigation and treatment of coronary disease impose a significant burden on health service resources. Catheter coronary angiography remains the gold standard for the investigation of suspected coronary disease. Given the invasive nature and high costs of invasive coronary angiography, there is an increased interest in noninvasive methods to image the lumen of the coronary arteries. Recent publications of the utility of 64-slice scanners indicate further improvement in both interpretability and diagnostic performance. When referral to catheterization is questionable, CT coronary angiography may identify subjects with normal angiograms and consistently decrease the number of unnecessary invasive procedures. Multislice CT coronary angiography of the clinically relevant coronary segments, as designated by the AHA classification, is now possible. Significant coronary stenoses were detected with the latest 64-slice CT scanner with a sensitivity of 99% and a specificity of 95% compared with conventional invasive diagnostic coronary angiography.