Coronary Screenings

Advanced Coronary Screening

CT Angiography

A new, non-invasive imaging test specifically designed for the coronary arteries.

Coronary CT angiography (CTA) is a contrast-enhanced CT angiogram that produces two- and three-dimensional images of the coronary arteries with the heart motion ‘frozen’ in diastole.

It is the only test that can detect, quantify and characterize atherosclerotic plaque—from the early stages of fatty streak, to lipid core, to fibrosis, and eventually to calcification. CTA can identify atherosclerotic plaque at risk of rupture that would not be detected by EKG or stress perfusion.

Although considered the ‘gold standard,’ invasive catheter angiography can only measure the vessel lumen and provide information about the disease process within the vessel wall. Compared to conventional angiography, CTA shows excellent correlation with sensitivities greater than 90% and negative predictive values of as high as 99%.

When is CT angiography appropriate?

While not intended as a replacement for cardiac catheterization, CTA is now considered an excellent alternative to catheterization and stress test in certain defined clinical situations:

  • Patients who have been screened with Doppler or rudimentary imaging and require quantification of carotid artery disease before proceeding to MRA or catheterization
  • Patients with certain types of chest symptoms or equivocal stress test—especially when the likelihood for an angioplasty is low
  • Patients for whom CAD is suspected but have passed a stress test
  • Patients who refuse a catheterization
  • Patients who require better evaluation of plaque morphology
  • Patients who have coronary stents or bypass grafts to verify that the arteries are open and functioning properly

Coronary Calcium Score

Until recently, coronary artery disease (CAD) has been one of the most difficult diseases to detect and prevent. Sole reliance on the failed Framingham Risk Assessment model is no longer clinically viable, thanks to the definitive evidence provided by the coronary calcium score, which has emerged to become one of the most validated tests in modern medicine.

Endorsements from the American Heart Association, American College of Cardiology, and NCEP ATP III in recent years has accelerated momentum for this test, and has finally given the calcium score—now more than a decade in existence—the credit it deserves.

For your intermediate risk patients, this low-cost, elective test can provide invaluable information for the primary care physician:

  • The coronary calcium score has been demonstrated to be five (5) times more accurate than Framingham at predicting which patients are at risk for coronary artery disease
  • Information gained from the calcium score can more accurately identify patients requiring cholesterol-lowering therapy, helping to reduce instances of unnecessary, costly medication
  • The test can also be used, over time, to effectively measure response to targeted therapy

The coronary calcium score is non-invasive, and the Aquilion 64-slice CT used in the procedure at Associated Radiologists of Clarkston delivers a lower radiation dose than previous generations of CT scanners.

After the test, the physician is issued a complete report, including a description of the scores and recommended treatment protocols. If desired, our cardiologists are available to discuss the results with you in greater detail.