[Role of cardiac CT-angiography in clinical routine--an update 2010]

Multi Detector CT, the usage of adequate technology, suitable imaging protocols, sufficient experience and strict patient selection provided, allows visualization of the heart with high temporal and spatial resolution. The main application is coronary CT angiography. Coronary artery stenoses can be detected with high sensitivity and specificity. Especially the high negative predictive value is high, but care has to be taken to avoid false-positive results which occur especially when image quality is degraded. Coronary CT angiography should not be considered a widespread replacement of invasive coronary angiography or even a "screening" procedure, but it can be clinically useful to rule out coronary artery stenoses in selected patients. The detection of coronary artery calcification can be used for risk stratification purposes. Finally, CT also allows evaluation of cardiac morphology and function, but will be used for this only when other modalities, such as echocardiography and MR imaging, have failed or are not applicable.