Coronary Angiography Using Noninvasive Imaging Techniques of Cardiac CT and MRI

Noninvasive coronary angiography has become an important imaging tool in the evaluation of patients with and at risk for coronary artery disease (CAD). Multidetector computed tomographic (MDCT) angiography offers excellent negative predictive value (>= 95%) for the absence of coronary artery disease and has shown promising results in evaluating allograft vasculopathy, bypass grafts, and degenerative aortic valve disease. A single MDCT scan in the emergency department is valuable in ruling out both cardiac and noncardiac causes of acute chest pain. Cardiac magnetic resonance (MR) currently lacks the spatial resolution of MDCT limiting its assessment of the coronary vasculature, but the proximal coronary arteries can be evaluated along with myocardial function and viability without exposure to contrast dye or ionizing radiation. In addition, MR imaging also has great potential for characterizing coronary plaques, as well as following their progression and regression.