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(Circulation. 2002;106:2036.)
© 2002 American Heart Association, Inc.

Editorial

Noninvasive Coronary Angiography Using Computed Tomography

Ready to Kick It Up Another Notch?

John A. Rumberger, PhD, MD

From The Ohio State University, OhioHeart, Columbus.

Correspondence to John A. Rumberger, PhD, MD, 765 N Hamilton Rd, Suite 103, Columbus, OH 43230. E-mail rumbj@attglobal.net

Key Words: Editorials • angiography • tomography • coronary disease • imaging

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Direct visualization of the epicardial coronary arteries is necessary to confirm the presence and/or focal severity of coronary luminal disease. For nearly 50 years,¹ invasive coronary arteriography has been the reference standard for defining epicardial coronary artery disease. While conventional coronary arteriography provides for exceptional spatial resolution and a general "road map" of the coronary system for catheter-based or surgical interventions, it is expensive, has a small but definite risk of complications, and requires either a brief hospitalization or a period of observation for several hours after the procedure in a specialized monitored unit. For many patients with known or suspected luminal coronary disease, a convenient, noninvasive, and safe means to perform coronary angiography would likely be of significant clinical and economic benefit.

See p 2051

Electron beam (computed) tomography (EBT) has for some time been the only well-validated computed tomography (CT)-based imaging method that could reliably characterize cardiac mechanics and perfusion and provide insight into coronary atherosclerosis.² The latter was accomplished initially by defining coronary artery calcification (CAC) and its relationship to atherosclerotic plaque.³ However, since the initial publications by Achenbach et al⁴ and Schmermund et al,⁵ EBT has been investigated increasingly as a means to perform noninvasive three-dimensional (3D) arteriography of the large epicardial coronary arteries, to examine coronary artery bypass grafts,⁶ and to characterize coronary artery anomalies.⁷ The published sensitivity and specificity of EBT for obstructive coronary disease as compared with invasive coronary arteriography has ranged from 85% to 90%. Recent changes in protocols to perform 1.5-mm . . . [Full Text of this Article]

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