Noninvasive assessment of coronary stenosis

Invasive coronary angiography (ICA) has been the gold standard in the diagnosis of coronary artery disease (CAD) for a long time and angiographic procedures performed annually in the United States have steadily increased during the last 25 years. The unmatched temporal and spatial imaging resolution, the high level contrast between the coronary lumen and the adjacent structures, and the ability to concurrently perform percutaneous coronary interventions (PCI) are the technical advantages of coronary angiography. However, the isolated intraluminal imaging, the relatively high financial cost of the procedure, and the risks associated with catheterization may be limitations to its use. Moreover, a better selection of patients really in need of ICA and PCI is necessary since many patients referred for ICA are found not to have significant CAD. Therefore, a remarkable technical progress has been achieved by both cardiac magnetic resonance and cardiac computed tomography in this regard for the noninvasive detection of coronary stenoses.