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CT evaluation of coronary artery disease

P. Pavone, M. Fioranelli, DA Dowe, Springer, 2009
Book Review by JF Paul, 
Centre Chirurgical Marie Lannelongue, Le Plessis-Robinson, France

Table of Contents»

CT coronary angiography is rapidly evolving, so a new source of comprehensive and up-to-date information on this topic is of interest to every radiologist and cardiologist involved in this field. There are many books on this topic, and all describe relevant anatomy, technical issues and radiological findings. The originality of this new book, CT evaluation of coronary artery disease, is to also provide the reader with information on the pathophysiology of coronary artery disease; this allows a deeper comprehension of the information provided by coronary CT angiography. The book also clearly explains important concepts in cardiology, such as the coronary reserve and the process of coronary plaque evolution.
This 157-page book, nicely illustrated, is divided in 13 chapters. Interestingly, one chapter is devoted to atherosclerotic plaque, introducing the key concept of a vulnerable plaque. The following chapter describes intravascular ultrasonography, a novel method for the evaluation of coronary plaque. In the subsequent chapter, the potential of CT angiography for coronary plaque evaluation is advocated, using selected clinical examples; this chapter is a useful attempt to guide the reader in the characterization of atherosclerotic plaque using coronary CT angiography. An important chapter on the evaluation of coronary stenosis and occlusion is well introduced, but practical details are missing to help users in daily practice. Coronary bypass evaluation is treated in a short chapter. A long chapter is dedicated to stent technology, underlying technological insights generally not known by radiologists. Unfortunately, the following chapter concerning the CT evaluation of stents is very short. The chapter concerning X-ray exposure presents the main facts in terms of radiation dose from coronary CT angiography. The issue of coronary CT in the emergency room is addressed and illustrated with a logical flow chart for the diagnosis of chest pain in the emergency room. Finally, the last chapter deals with the prognostic value of coronary CT.
In conclusion, this comprehensive book provides relevant pathophysiological information necessary for a good approach to coronary CT angiography. It is nicely illustrated. However, one may regret that the references are not given within the text of each chapter (only suggested reading is provided at the end of the text). Some chapters are really too short and some important topics are missing. For example, a chapter on the evaluation of myocardial infarction with CT should be added, as it is directly a part of the CT evaluation of coronary artery disease. This book may be recommended to radiologists who need information on pathophysiology and anatomy in coronary artery disease.


 
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