Can coronary artery CT diagnose coronary heart disease?

Coronary artery CT (coronary CT angiography) can be used to diagnose coronary artery disease, but it is not absolutely definitive, with an accuracy of approximately 85%. This examination involves the rapid intravenous injection of iodinated contrast agent through a peripheral vein. When the contrast concentration in the coronary arteries reaches its peak, continuous volumetric data acquisition is performed using CT. Subsequently, computer post-processing reconstructs anatomical images of the coronary arteries, allowing evaluation of their morphology and lumen. Coronary artery CT provides a highly intuitive display of the course and structure of the coronary arteries, as well as the presence and extent of atherosclerosis. If coronary CT shows stenosis exceeding 50% in the coronary arteries, combined with the patient's clinical symptoms, a diagnosis of coronary artery disease can be made. However, in certain special situations, such as severe coronary artery calcification or patients with rapid arrhythmias, coronary artery CT may not provide an accurate diagnosis. For patients with a high suspicion of coronary artery disease, coronary angiography remains the gold standard.