Abstract
We describe a significant left anterior descending coronary lesion in a patient with unstable angina pectoris. This lesion was erroneously underestimated using quantitative coronary angiography; however, CT coronary angiography correctly showed a significant, elongated, eccentric, soft plaque that was later confirmed by repeated quantitative coronary angiography with intravascular ultrasound. As showed, CT coronary angiography may offer a reliable non-invasive alternative to quantitative coronary angiography and intravascular ultrasound by enabling a true 3-D coronary lumenogram combined with plaque detection and characterization.