2016 Volume 62 Issue 3 Pages 190-196
Coronary CT angiography (CCTA) has become widely used as a tool that enables the noninvasive evaluation of coronary artery stenosis and plaque. Evidence of the accuracy of CCTA for the diagnosis of angina has been established and its incremental value combined with the coronary artery calcium score obtained by plain CT has been proven. Regarding evaluation of plaques, while there have been reports that CCTA is useful for detecting vulnerable plaques associated with a high incidence of acute coronary syndrome, problems remain in relation to subjective and quantitative evaluation. In addition, although coronary atherosclerosis is often detected clinically in asymptomatic high-risk patients, evidence has not yet been obtained that CCTA can be used for risk assessment in asymptomatic patients. Although severe coronary artery calcification was a major problem that interfered with assessment of the severity of stenosis, the recent development of subtraction CCTA imaging has overcome this problem in some cases. As for radiation exposure, this has been reduced considerably by new developments in equipment and imaging protocols, as well as advances of reconstruction techniques.
Thanks to remarkable advances in CT scanners and the development of new imaging and analysis techniques, CCTA is expected to become even more useful for the diagnosis of coronary artery disease and re-stratifying risk in many patients, and its applications will expand further in the future.
