Provides high-resolution images of cardiac structures (including the pericardium and cardiac masses) and detects coronary calcification in atherosclerosis with high sensitivity. CT angiography (CTA) delineates abnormalities of the great vessels, including aortic aneurysms and dissection, and pulmonary embolism. Multislice spiral CT provides high-resolution images of coronary anatomy. It is most useful in evaluation of suspected coronary anatomic anomalies and to exclude high-grade coronary stenoses in pts with chest pain and intermediate pretest probability of coronary artery disease. Its greatest accuracy is in detection of left main and proximal LAD and circumflex disease. CTA is also helpful in assessing the patency of bypass grafts.

Table 114-2 Selection of Imaging Tests summarizes key diagnostic features of the noninvasive imaging modalities. Figure 114-3. Flow Diagram for Selection of Stress Testing in a Pt with Chest Pain provides an algorithm for diagnostic imaging assessment of suspected CAD.