Coronary CT Angiography in the Quantitative Assessment of Coronary Plaques

Abstract

Coronary computed tomography angiography (CCTA) has been recently evaluated for its ability to assess coronary plaque characteristics, including plaque composition. Identification of the relationship between plaque composition by CCTA and patient clinical presentations may provide insight into the pathophysiology of coronary artery plaque, thus assisting identification of vulnerable plaques which are associated with the development of acute coronary syndrome. CCTA-generated 3D visualizations allow evaluation of both coronary lesions and lumen changes, which are considered to enhance the diagnostic performance of CCTA. The purpose of this review is to discuss the recent developments that have occurred in the field of CCTA with regard to its diagnostic accuracy in the quantitative assessment of coronary plaques, with a focus on the characterization of plaque components and identification of vulnerable plaques.

Comparative Trends and Downstream Outcomes of Coronary Computed Tomography Angiography and Cardiac Stress Testing in Emergency Department Patients With Chest Pain: An Administrative Claims Analysis

“…CCTA differs from other noninvasive modalities in that it assesses coronary anatomy but does not assess cardiac function. The presence of coronary calcium on CCTA does not necessarily indicate a hemodynamically significant flow limiting lesion, and the relationship between the degree of calcification and ACS is difficult to evaluate . This could lead to overtesting, especially if patients are not carefully selected for CCTA and providers are inexperienced in interpreting the results.…”

Virtual Intravascular Endoscopy Visualization of Calcified Coronary Plaques

“… 18 , 19 The less-invasive approach to identify the morphological features of calcified plaques is through 3D virtual intravascular endoscopy (VIE), which has been shown to provide additional information of the coronary wall and plaques. 20 – 22 Identification of intraluminal appearances of calcified plaques is considered to allow more accurate assessment of coronary stenosis by detecting superficial and deep calcified plaques. Thus, the purpose of this study is to investigate the feasibility of using 3D VIE as a novel approach to differentiate superficial from deep calcified plaques, and determine the accuracy of assessing coronary lumen stenosis when compared with ICA.…”

Assessment of calcification of the coronary arteries and long-term prognosis of cardiovascular disease

“…Для выявления морфологических особенностей кальцифицированных бляшек используют виртуальную внутрисосудистую ýндоскопию 3D, которая, как было показано, предоставляет до-Бюллетень сибирской медицины. 2020; 19 (1): 172-179 полнительную информацию о стенке коронарных артерий и бляшках [7]. В последнее время на смену классической КАГ пришли внутрисосудистое ультразвуковое исследование и оптическая когерентная томография.…”

“…Этот метод имеет целый ряд преимуществ, таких как высокое разрешение датчиков, краткосрочное проведение исследования, возможность реконструкции наглядных и удобных для интерпретации изображений в различных плоскостях. Однако метод имеет ограничения по глубине проникновения через ткани, которая составляет <2 мм, и ýто значительно влияет на роль ОКТ в оценке бляшек [7,12].…”