Cardiac computed tomography

Advances in computed tomography (CT) technology now allow definitive imaging of the coronary arteries. Non-enhanced CT is used to perform coronary artery calcium scoring, which is useful to stratify the risk of future coronary events but does not allow assessment of stenosis. Contrast-enhanced CT coronary angiography (CTCA) enables angiographic evaluation of both the coronary artery lumen and wall. The high negative predictive accuracy of CTCA makes it a useful test to rule out the presence of significant coronary stenoses, especially in patients with an intermediate pre-test likelihood of coronary artery disease. CTCA also has potential to aid the triage of patients with acute chest pain in the emergency department. CTCA can determine the approximate degree of stenosis as well as detect high-risk plaque characteristics. Coronary artery bypass grafts can be assessed reliably using CT. Intracoronary stent evaluation is possible because of advances in temporal resolution. Myocardial perfusion imaging using cardiac CT is the subject of current investigation.