Complementary imaging techniques: Multislice computed tomography of coronary arteries

The introduction of 4-slice computed tomography (CT) was followed by revolutionary advances in multislice computed tomography (MSCT) technology. The main clinical focus of MSCT in cardiac imaging is the evaluation of the coronary arteries. MSCT systems have two principal modes of scanning. The first mode is sequential scanning, also known as “step-andshoot”, in which the table is advanced in a step-wise fashion. The second mode is spiral or helical scanning, in which the table moves continuously at a fixed speed relative to the gantry rotation. Good contrast enhancement in coronary arteries is essential for the detection of atherosclerotic changes and luminal stenosis. Patients with prior coronary artery bypass grafts (CABG) surgery usually present with comorbidity and have a higher prevalence of valve disease and ventricular dysfunction than non-CABG patients. They have a higher incidence of complications during invasive procedures, including cardiac catheterization, and can therefore benefit from non-invasive coronary angiography performed by MSCT.