Abstract
Coronary computed tomography angiography (CCTA) is widely used as a noninvasive cardiovascular imaging modality that allows visualization of both calcified and noncalcified atherosclerotic plaques and exclusion of coronary luminal stenoses with high diagnostic performance. However, high (>400) coronary artery calcium score (CACS) may increase the false-positive rate and decease diagnostic accuracy due to beam-hardening artifacts resulting from heavily calcified plaques. For patients with high CACS cannot be reliably evaluated with CCTA and invasive coronary angiography (ICA) is frequently recommended in routine clinical practice. Recently, dual-energy CT (DECT) has been introduced to reduce beam-hardening artifacts and improve the diagnostic performance of CCTA in patients with severe coronary calcification. In this chapter, we will investigate the implication of CACS and further discuss the application of DECT in patients with CACS.
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