How accurate is a coronary ct angio to check for plaque and blockages? can it see soft and hard plaque?

Yes: A technically well done study is rather accurate in detecting occult CAD, soft and hard plaque, and ofcourse, the reporting also depends on user experience. Whether the blockages are hemodynamically or clinically significant then, depends on whether you have sxs, correlation clinically, and as to why test ordered in the first place. CT angio is static; only if FFR done u also get functional info