Current clinical applications of cardiac computed tomography.

Multi-detector row CT allows high-resolution anatomic and functional visualization of the heart. The main current clinical application is non-invasive coronary angiography after intravenous injection of contrast agent. Coronary CT angiography permits the detection of coronary artery stenoses with relatively high accuracy and especially high negative predictive value. It is therefore considered clinically useful to rule out disease and avoid invasive coronary angiography in patients with low to intermediate likelihood of disease and especially with equivocal stress test results. Of lesser clinical relevance, albeit indicated in certain patient subgroups, is the use of cardiac computed tomography for coronary calcium quantification in the context of risk stratification. Finally, the analysis of cardiac morphology and function, including the assessment of valvular disease, is possible by CT. For most of these applications, CT is only indicated if more standard techniques such as echocardiography or cardiac magnetic resonance fail. Correct patient selection as well as sufficient experience and expertise are prerequisites for the beneficial clinical application of coronary CT angiography.