Background: Recent advances in computed tomography (CT) has made noninvasive imaging of the coronary arteries possible. Multidetector-CT (MDCT)-scanners capable of visualizing the coronary arteries will be available in most Norwegian hospitals within a few years. If the examinations have acceptable quality, diagnostics of coronary pathology could to some extent be decentralized.
Material and methods: Our overview is based on non-systematic review of relevant literature, as well as our own experience.
Results and discussion: Good results have been shown for 16 and especially for 64 detector scanners in several comparative studies with invasive coronary angiography. The predictive value of a negative test is impressive in all the published studies. Significant coronary pathology is unlikely with a normal MDCT investigation of good quality, but MDCT's imprecise assessment of stenoses generates too many false positive findings. CT-technology is evolving rapidly. Yet, variable image quality and a high radiation dose are still challenging, even with modern CT-scanners.
Interpretation: We advocate against uncritical use of the method, however, there is reason for optimism regarding the method's future contribution to coronary diagnostics.