Coronary Computed Tomography Angiography

Coronary computed tomography angiography (CCTA) is a noninvasive imaging modality that provides detailed 3D visualization of coronary arteries for diagnosing coronary artery disease (CAD). This chapter outlines technical protocols, including patient preparation (heart rate control, contrast administration, ECG synchronization), scanning techniques (prospective/retrospective gating, radiation optimization), and advanced image reconstruction/post-processing methods (iterative algorithms, CT-FFR). It highlights clinical applications such as screening asymptomatic individuals, evaluating stable/acute chest pain, and assessing post-revascularization outcomes. Updated guidelines, including CAD-RADS 2.0, standardize stenosis grading, plaque burden assessment, and modifiers (e.g., high-risk plaques, ischemia). CCTA’s high negative predictive value and integration of anatomical/functional data position it as a pivotal tool in CAD diagnosis, reducing unnecessary invasive procedures while optimizing patient management.