New trends in non-invasive coronary angiography with multislice CT.

Recent trends in computed tomography (CT) scanner technology has opened new frontiers in the field of non-invasive coronary angiography. Given the relatively important number of negative invasive angiographies performed each year, eliminating the risks inherent to this procedure by non-invasive methods greatly contribute to diminishing the risk. After injection of contrast, the procedure is performed under short apnea and triggered by electrocardiographic (ECG) recording that provides a multitude of possible image reconstructions; ie, volume rendering, virtual angioscopy, and three-dimensional (3D) reconstruction of the heart and coronary vessels. In 100 patients, adequate visualisation of the coronary arteries was achieved in 98%, with the advantage of visualizing the coronary wall as well as the lumen. The main reasons for failure were arrhythmia and excessive motion. Besides evaluating coronary artery atherosclerosis, computed tomography angiography (CTA) allowed the diagnosis of coronary aneurysm and exact localization of postoperative false aneurysm. The main disadvantages of the technique are the absence of dynamic films and exposure to radiation. The increased accuracy and sensitivity of noninvasive coronary angiography make it an excellent diagnostic tool and a probable replacement to invasive procedures. It should reduce the morbidity and mortality as well as the cost of conventional coronary arteriography. Furthermore, it has the added benefit of offering spacial resolution of the examined vessels.