Noninvasive Coronary Artery Imaging

Abstract

Current computed tomography (CT) technology enables the noninvasive imaging of the coronary arteries in daily clinical practice. Patients with a low to intermediate likelihood of coronary artery disease (CAD) and having equivocal findings at electrocardiogram (ECG) or stress tests are considered suitable candidates to undergo noninvasive coronary CT angiography. The excellent negative predictive value close to 100 % enables the exclusion of obstructive CAD with certainty. In order to obtain images without artifacts, CT scanner systems need to provide a high temporal and spatial resolution. In addition, several techniques must be applied and combined for minimizing the exposure of patients to ionizing radiation. CT data acquisition needs to be synchronized to the simultaneously recorded ECG for either retrospective, prospective, or high-pitch scanning. Depending on the heart rate of the patients, ECG pulsing windows must be flexibly adjusted. Owing to the steadily increasing temporal resolution of modern CT systems, coronary CT angiography today is possible even at high and/or irregular heart rates.