Coronary CT Angiography

Cardiac CT angiography is a new way to non-invasively evaluate cardiac anatomy, including coronary arteries, great arteries and veins, cardiac chambers, muscle, and valves. Coronary arteries can be evaluated for the presence of anatomic anomalies, plaques, stenoses, and occlusions. Information on bypass graft patency and other postsurgical status can also be obtained. The great vessels can be examined for the presence of abnormalities such as aneurysm, dissection, thrombus, and congenital anomalies. Cardiac CT angiography can also provide assessments of abnormalities of and within the cardiac chambers including the presence and extent of cardiac masses, ventricular aneurysm, and abnormal anatomic connections (e.g. atrial or ventricular septal defects). In addition, since multiplanar imaging reconstruction can be performed with Cardiac CT angiography, high resolution three-dimensional images of the heart and blood vessels can be flexibly created, allowing for a better understanding and display of complex anatomic abnormalities than with many other imaging techniques.

Cardiac CT angiography of the coronary arteries (usually reimbursable) has been shown to be a very reliable way to diagnose the presence or absence of significant coronary artery disease (sensitivities of 92-95% and negative predictive values of greater than 97%). In the past, this information could only be reliably obtained with a cardiac catheterization. With the use of multidector CT systems, Cardiac CT angiography allows for imaging of the heart and coronary arteries in seconds. The high negative predictive value of Cardiac CT angiography can usually prevent patients without significant cardiac disease from needing to undergo unnecessary cardiac catheterization. Also, demonstration of calcified and/or soft plaque accumulation in asymptomatic patients can provide a sound rationale for the initiation of lipid lowering therapy.

 

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