[Non-invasive coronary artery imaging using multislice computed tomography].

Abstract

Coronary atherosclerotic disease is the leading cause of mortality in industrialized countries. The disease can remain silent for years, being diagnosed only after acute myocardial infarction in about 50% of cases. Coronary angiography is the reference standard for coronary imaging. However, it is invasive and costly, requiring intra-arterial catheterization. In addition, coronary angiography does not visualize the arterial wall, but only the lumen. A reliable non-invasive imaging technique showing changes in both the arterial wall and the lumen would be highly useful, especially for early diagnosis. Recently, multislice computed tomography (CT) was shown to be capable of visualizing not only the coronary arteries (lumen and wall), but also the cardiac muscle, with high spatial resolution. Multislice CT provides high-quality 3D images of coronary arteries. Initial results with 4, 16 and now 64-slice CT, by comparison with conventional angiography, are very promising, and multislice CT technology is advancing rapidly. Non-invasive visualization of the coronary arteries with accurate detection of stenosis is now possible in practice using ECG-gated 16-slice CT Multislice CT can also detect non stenotic coronary plaque. Finally, visualization of cardiac muscle by multislice CT makes it possible to detect myocardial ischemia.