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Coronary CT Angiography

Article information

J Korean Med Assoc. 2003;46(11):1009-1015
Publication date (electronic) : 2003 November 30
doi : https://doi.org/10.5124/jkma.2003.46.11.1009
Byoung Wook Choi, M.D.
Department of Diagnostic Radiology, Yonsei University College of Medicine, Severance Hospital, Korea. bchoi@yumc.yonsei.ac.kr

Abstract

With the advent of multislice computed tomography (MSCT), noninvasive coronary angiography by using CT has become practical for clinical purposes. The accuracy of MSCT in evaluation of coronary artery stenosis challenges that of conventional X-ray coronary arteriography. The essential component of the CT technique in evaluation of coronary arteries on a beating heart consists of a multidetector row system, which enables thin-sliced volume scan during one breath-hold, and the fast rotation speed of gantry, which is most important to increase the time resolution. However, the technical development so far achieved just allows CT to acquire diagnostic-quality images only with lowering the heart rate less than 65 beats per minute using a β-blocker. Motion artifacts caused by physiologic or diseased complex movement of the heart and blooming artifacts from dense calcification are the major limitations compromising accurate interpretation of coronary CT angiograms. Although many problems related to coronary CT angiography has not been solved at present, we should remember that the present CT technique is just at its infancy, and CT has many benefits as a noninvasive diagnostic modality. In addition, measurement of a cross-sectional area at stenosis of coronary artery will improve diagnostic accuracy, which is also a major advantage over the projection image of X-ray angiography. Characterization of a vulnerable plaque by density measurement of an atherosclerotic plaque of the coronary vessel wall and evaluation of in-stent restenosis should be other possibilities of CT.

Keywords: Computed tomography (CT); Coronary disease; Stenosis; Angiography

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Copyright © 2003 Korean Medical Association

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