Quantification of coronary artery stenoses by computed tomography.

Coronary computed tomography (CT) angiography is being increasingly employed for the evaluation of coronary artery disease (CAD). Recent publications using 64-slice CT (1,2), and dual-source CT (3,4) have demonstrated high accuracy for the detection of coronary stenoses in comparison with invasive angiography. The high negative predictive value makes CT angiography an especially attractive tool to rule out CAD with a degree of certainty and confidence that is higher than any other noninvasive and more indirect tests, such as myocardial perfusion imaging (5). A recent expert consensus document has proposed appropriate indications for coronary CT angiography, which include chronic stable angina with intermediate likelihood of CAD and equivocal results of a stress test, as well as acute chest pain with an intermediate likelihood of CAD based on clinical assessment and noncontributory enzymes, or electrocardiogram changes (6).