Skip to main content
SpringerLink
Log in

Diagnostic performance of CT coronary angiography for the detection of obstructive coronary artery disease

  • Published:
Current Cardiovascular Imaging Reports Aims and scope Submit manuscript

Abstract

CT coronary angiography (CTCA) is emerging as the most promising imaging modality for noninvasive detection of atherosclerotic disease of the coronary arteries. The possibility to identify or rule out significant coronary stenosis, to measure atherosclerotic plaque burden, and to characterize plaque components makes this imaging modality very enticing. This review briefly summarizes CTCA’s technical aspects, limitations, and pitfalls, as well as different methods of analyses of diagnostic performance of CTCA. It also provides clinical indications for the use of CTCA and discusses its use in patients with prior coronary stent placement and coronary artery bypass grafting.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References and Recommended Reading

  1. Gibbons RJ, Abrams J, Chatterjee K, et al.: ACC/AHA 2002 guideline update for the management of patients with chronic stable angina—summary article: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on the Management of Patients With Chronic Stable Angina). Circulation 2003, 107:149–158.

    Article  PubMed  Google Scholar 

  2. Gibbons RJ, Balady GJ, Bricker JT, et al.: ACC/AHA 2002 guideline update for exercise testing: summary article: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1997 Exercise Testing Guidelines). Circulation 2002, 106:1883–1892.

    Article  PubMed  Google Scholar 

  3. Schinkel AF, Bax JJ, Geleijnse ML, et al.: Noninvasive evaluation of ischaemic heart disease: myocardial perfusion imaging or stress echocardiography? Eur Heart J 2003, 24:789–800.

    Article  CAS  PubMed  Google Scholar 

  4. Abdulla J, Abildstrom SZ, Gotzsche O, et al.: 64-multislice detector computed tomography coronary angiography as potential alternative to conventional coronary angiography: a systematic review and meta-analysis. Eur Heart J 2007, 28:3042–3050.

    Article  PubMed  Google Scholar 

  5. Hamon M, Morello R, Riddell JW, Hamon M: Coronary arteries: diagnostic performance of 16-versus 64-section spiral CT compared with invasive coronary angiography—meta-analysis. Radiology 2007, 245:720–731.

    Article  PubMed  Google Scholar 

  6. Mowatt G, Cook JA, Hillis GS, et al.: 64-Slice computed tomography angiography in the diagnosis and assessment of coronary artery disease: systematic review and meta-analysis. Heart 2008, 94:1386–1393.

    Article  CAS  PubMed  Google Scholar 

  7. Stein PD, Yaekoub AY, Matta F, Sostman HD: 64-slice CT for diagnosis of coronary artery disease: a systematic review. Am J Med 2008, 121:715–725.

    Article  PubMed  Google Scholar 

  8. Vanhoenacker PK, Heijenbrok-Kal MH, Van Heste R, et al.: Diagnostic performance of multidetector CT angiography for assessment of coronary artery disease: meta-analysis. Radiology 2007, 244:419–428.

    Article  PubMed  Google Scholar 

  9. Oncel D, Oncel G, Tastan A: Effectiveness of dual-source CT coronary angiography for the evaluation of coronary artery disease in patients with atrial fibrillation: initial experience. Radiology 2007, 245:703–711.

    Article  PubMed  Google Scholar 

  10. Pontone G, Andreini D, Bartorelli AL, et al.: Diagnostic accuracy of coronary computed tomography angiography: a comparison between prospective and retrospective electrocardiogram triggering. J Am Coll Cardiol 2009, 54:346–355.

    Article  PubMed  Google Scholar 

  11. Budoff MJ, Dowe D, Jollis JG, et al.: Diagnostic performance of 64-multidetector row coronary computed tomographic angiography for evaluation of coronary artery stenosis in individuals without known coronary artery disease: results from the prospective multicenter ACCURACY (Assessment by Coronary Computed Tomographic Angiography of Individuals Undergoing Invasive Coronary Angiography) trial. J Am Coll Cardiol 2008, 52:1724–1732.

    Article  PubMed  Google Scholar 

  12. Meijboom WB, Meijs MF, Schuijf JD, et al.: Diagnostic accuracy of 64-slice computed tomography coronary angiography: a prospective, multicenter, multivendor study. J Am Coll Cardiol 2008, 52:2135–2144.

    Article  PubMed  Google Scholar 

  13. Miller JM, Rochitte CE, Dewey M, et al.: Diagnostic performance of coronary angiography by 64-row CT. N Engl J Med 2008, 359:2324–2336.

    Article  CAS  PubMed  Google Scholar 

  14. Meijboom WB, van Mieghem CA, Mollet NR, et al.: 64-slice computed tomography coronary angiography in patients with high, intermediate, or low pretest probability of significant coronary artery disease. J Am Coll Cardiol 2007, 50:1469–1475.

    Article  PubMed  Google Scholar 

  15. Meijboom WB, Van Mieghem CA, van Pelt N, et al.: Comprehensive assessment of coronary artery stenoses: computed tomography coronary angiography versus conventional coronary angiography and correlation with fractional flow reserve in patients with stable angina. J Am Coll Cardiol 2008, 52:636–643.

    Article  PubMed  Google Scholar 

  16. Schuijf JD, Wijns W, Jukema JW, et al.: Relationship between noninvasive coronary angiography with multislice computed tomography and myocardial perfusion imaging. J Am Coll Cardiol 2006, 48:2508–2514.

    Article  PubMed  Google Scholar 

  17. Hoffmann MH, Shi H, Schmitz BL, et al.: Noninvasive coronary angiography with multislice computed tomography. JAMA 2005, 293:2471–2478.

    Article  CAS  PubMed  Google Scholar 

  18. Leber AW, Knez A, von Ziegler F, et al.: Quantification of obstructive and nonobstructive coronary lesions by 64-slice computed tomography: a comparative study with quantitative coronary angiography and intravascular ultrasound. J Am Coll Cardiol 2005, 46:147–154.

    Article  PubMed  Google Scholar 

  19. Raff GL, Gallagher MJ, O’Neill WW, Goldstein JA: Diagnostic accuracy of noninvasive coronary angiography using 64-slice spiral computed tomography. J Am Coll Cardiol 2005, 46:552–557.

    Article  PubMed  Google Scholar 

  20. Min JK, Shaw LJ, Devereux RB, et al.: Prognostic value of multidetector coronary computed tomographic angiography for prediction of all-cause mortality. J Am Coll Cardiol 2007, 50:1161–1170.

    Article  PubMed  Google Scholar 

  21. Gilard M, Le Gal G, Cornily JC, et al.: Midterm prognosis of patients with suspected coronary artery disease and normal multislice computed tomographic findings: a prospective management outcome study. Arch Intern Med 2007, 167:1686–1689.

    Article  PubMed  Google Scholar 

  22. Ostrom MP, Gopal A, Ahmadi N, et al.: Mortality incidence and the severity of coronary atherosclerosis assessed by computed tomography angiography. J Am Coll Cardiol 2008, 52:1335–1343.

    Article  PubMed  Google Scholar 

  23. Ghostine S, Caussin C, Daoud B, et al.: Non-invasive detection of coronary artery disease in patients with left bundle branch block using 64-slice computed tomography. J Am Coll Cardiol 2006, 48:1929–1934.

    Article  PubMed  Google Scholar 

  24. Gilard M, Cornily JC, Pennec PY, et al.: Accuracy of multislice computed tomography in the preoperative assessment of coronary disease in patients with aortic valve stenosis. J Am Coll Cardiol 2006, 47:2020–2024.

    Article  PubMed  Google Scholar 

  25. Meijboom WB, Mollet NR, Van Mieghem CA, et al.: Preoperative computed tomography coronary angiography to detect significant coronary artery disease in patients referred for cardiac valve surgery. J Am Coll Cardiol 2006, 48:1658–1665.

    Article  PubMed  Google Scholar 

  26. Mollet NR, Hoye A, Lemos PA, et al.: Value of preprocedure multislice computed tomographic coronary angiography to predict the outcome of percutaneous recanalization of chronic total occlusions. Am J Cardiol 2005, 95:240–243.

    Article  PubMed  Google Scholar 

  27. Gilard M, Cornily JC, Rioufol G, et al.: Noninvasive assessment of left main coronary stent patency with 16-slice computed tomography. Am J Cardiol 2005, 95:110–112.

    Article  PubMed  Google Scholar 

  28. Van Mieghem CA, Cademartiri F, Mollet NR, et al.: Multislice spiral computed tomography for the evaluation of stent patency after left main coronary artery stenting. A comparison with conventional coronary angiography and intravascular ultrasound. Circulation 2006, 114:645–653.

    Article  PubMed  Google Scholar 

  29. Malagutti P, Nieman K, Meijboom WB, et al.: Use of 64-slice CT in symptomatic patients after coronary bypass surgery: evaluation of grafts and coronary arteries. Eur Heart J 2006, 28:1879–1885.

    Article  PubMed  Google Scholar 

  30. Ropers D, Pohle FK, Kuettner A, et al.: Diagnostic accuracy of noninvasive coronary angiography in patients after bypass surgery using 64-slice spiral computed tomography with 330-ms gantry rotation. Circulation 2006, 114:2334–2341; quiz 2334.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Cardiology and Radiology, Erasmus Medical Center, Rotterdam, The Netherlands

    Willem Bob Meijboom

Authors
  1. Willem Bob Meijboom
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Willem Bob Meijboom.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Meijboom, W.B. Diagnostic performance of CT coronary angiography for the detection of obstructive coronary artery disease. curr cardiovasc imaging rep 2, 389–395 (2009). https://doi.org/10.1007/s12410-009-0049-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12410-009-0049-y

Keywords

Search

Navigation