[Visualization of Borderline Coronary Artery Lesions by CT Angiography and Coronary Artery Disease Reporting and Data System].

Journal of the Korean Society of Radiology Pub Date : 2024-03-01 Epub Date: 2024-03-27 DOI:10.3348/jksr.2023.0141
Hyewon Park, Yu-Whan Oh, Ki Yeol Lee, Hwan Seok Yong, Cherry Kim, Sung Ho Hwang
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Abstract

Coronary artery disease (CAD) narrows vessel lumens at the sites of atherosclerosis, increasing the risk of myocardial ischemia or infarction. Early and accurate diagnosis of CAD is crucial to significantly improve prognosis and management. CT angiography (CTA) is a noninvasive imaging technique that enables assessment of vascular structure and stenosis with high resolution and contrast. Coronary CTA is useful in the diagnosis of CAD. Recently, the CAD-reporting and data system (CAD-RADS), a diagnostic classification system based on coronary CTA, has been developed to improve intervention efficacy in patients suspected of CAD. While the CAD-RAD is based on CTA, it includes borderline categories where interpreting the coronary artery status solely based on CTA findings may be challenging. This review introduces CTA findings that fall within the CAD-RADS categories that necessitate additional tests to decide to perform invasive coronary angiography and discusses appropriate management strategies.

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[通过 CT 血管造影和冠状动脉疾病报告和数据系统观察冠状动脉边缘病变]。
冠状动脉疾病(CAD)使动脉粥样硬化部位的血管管腔变窄,增加了心肌缺血或梗死的风险。CAD 的早期准确诊断对于显著改善预后和治疗至关重要。CT 血管造影(CTA)是一种无创成像技术,能以高分辨率和对比度评估血管结构和狭窄情况。冠状动脉 CTA 对诊断 CAD 非常有用。最近,基于冠状动脉 CTA 的诊断分类系统--CAD 报告和数据系统(CAD-RADS)被开发出来,以提高对疑似 CAD 患者的干预效果。虽然 CAD-RAD 以 CTA 为基础,但它也包括一些边缘类别,在这些类别中,仅根据 CTA 检查结果来解释冠状动脉状况可能具有挑战性。本综述介绍了属于 CAD-RADS 类别的 CTA 结果,这些类别需要进行更多检查才能决定是否进行有创冠状动脉造影,并讨论了适当的管理策略。
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