The recent technical developments of computed tomography (CT) have made it possible to visualize the coronary arteries with a noninvasive imaging method, similarly to what happened a few years ago regarding other, less challenging but nevertheless important, vascular districts. Coronary CT angiography has given new enthusiasm to radiologists and cardiologists interested in cardiac imaging. Still, knowledge of the field is relatively limited and there is a great need for textbooks to help young and even well-trained physicians face this new imaging modality.

The Atlas of Cardiovascular CT provides all the information needed, including technical and clinical aspects. Although this book is conceived as an atlas, it also contains a textual part that provides the essential notions necessary for reading each chapter. The iconography of this book is of extremely high quality, with a large number of drawings as well as colour and black and white illustrations. In most instances, coronary CT angiography is compared with selective coronary angiography, demonstrating the excellent agreement between the two methods.

After an introductory chapter that provides a historical background and suggests future directions in coronary artery imaging, the next two chapters are dedicated to the performance of a coronary CT angiography examination. Emphasis is given to patient preparation, clinically and from the scanning point of view. Image acquisition is also discussed, referring to scanners with up to 64 detector rows, but the information can also be applied to newer scanners. The authors explain how to post-process the images, and provide notions on which are the best views and rotations to outline each coronary artery disease. Regarding contrast medium delivery, the authors provide an outline on contrast kinetics, discuss the variability that may occur in different patients, and suggest injection protocols that permit one to achieve homogeneous contrast enhancement.
Before clinical applications are discussed, Chapter 4 illustrates normal coronary anatomy and the most common anatomical variants, both benign and malignant. Extraordinarily high quality images accompanied by explanatory diagrams illustrate all anatomical conditions. Additional examples of benign and malignant anomalies are given later, in Chapter 10. Then, the atlas offers a series of chapters dedicated to different clinical presentations. Chapter 5, on coronary artery disease, starts with an exhaustive literature review of the diagnostic performance of MDCT, compared to selective coronary angiography, in the depiction of significant stenoses. Based on the American Heart Association model, a segmental approach for assessing significant and non-significant coronary lesions is then proposed and corroborated by a large number of figures.  Chapter 6 is dedicated to MDCT imaging after coronary intervention and stenting, and focuses on the potentials and limitations of MDCT. Stent-related beam hardening artefacts are reviewed and correlated with stent strut characteristics and spatial resolution of the scanners. Many examples of left main and proximal epicardial vessels as well as by-pass stents are displayed and matched with corresponding angiographic images.

After an initial overview of the natural history of coronary artery by-pass grafts, Chapter 7 shows the relevant and well-established clinical role of MDCT for noninvasive assessment of both proximal and distal anastomoses and native coronary vessels. The pertinent literature is reviewed and nice examples of arterial and venous conduits are shown.  Plaque composition is emphasized in Chapter 8, which illustrates the differences between a luminographic technique such as coronary angiography and a three-dimensional acquisition such as coronary CT angiography that provides information on both vascular lumen and walls. Some examples of the correlation between MDCT and intravascular ultrasonography are also given.

In Chapter 9, calcium scoring is discussed, especially regarding its importance in clinical practice, while Chapter 10 addresses congenital heart diseases, showing the usefulness of CT angiography also in comparison to other noninvasive imaging modalities such as MRI and ultrasonography. The aorta and peripheral arteries (including the carotids) are also included in this atlas in Chapter 11, which provides basic clinical concepts and a few explicative cases useful in daily clinical practice.

The subsequent three chapters deal with important topics for which CT is rarely used but could soon find application: electrophysiology; intracardiac, myocardial and extracardiac anomalies; and myocardial function and viability.  Finally, the last two chapters explore the role of CT in emergency conditions, particularly in ruling out possible causes of acute chest pain, and discuss the approach to investigating incidental findings (particularly lung neoplasms).

This atlas is, in my opinion, the most complete you will find. I strongly recommend it to any physician, either still in training or already practicing, who wishes to start a new adventure with coronary CT angiography.