Non-invasive coronary angiography using multi-detector computed tomography - Update 2008; [Nichtinvasive Koronarangiographie mittels Mehrzeilen-Spiral-CT - Update 2008]

Non-invasive visualization of the coronary arteries and detection of significant coronary artery stenosis using conventional CT technology started in the year 1999 when 4-slice multi-detector CT (MDCT) systems were introduced. In the following years, spatial and technical resolution of MDCT coronary angiography rapidly evolved. State of the art 64-slice CT systems with a spatial resolution of up to 0.4 mm and rotation times below 300 ms provide a very reliable evaluation of the heart and the coronary arteries. Due to a consistently high negative predictive value, MDCT coronary angiography has demonstrated to be a useful imaging modality to exclude significant coronary artery stenosis especially in patients with a low to intermediate pretest likelihood. Prominent recent technical developments, e.g., dual-source CT technology or 320-slice MDCT, as well as the development of dose saving scan protocols will further improve the use of CT coronary angiography. This review summarizes the available literature concerning diagnostic accuracy, prognostic relevance and radiation exposure. Current scientific statements concerning possible clinical indications of CT coronary angiography are included.