Cardiology Service, Walter Reed National Military Medical Center, Bethesda, MD, USA.
Curr Cardiol Rep. 2012 Feb;14(1):7-16. doi: 10.1007/s11886-011-0226-x.
Coronary computed tomography angiography (CTA) is an increasingly utilized, highly accurate noninvasive test for the diagnosis of coronary artery disease. Accumulating data have convincingly demonstrated that the presence, extent, and location of both obstructive and nonobstructive coronary atherosclerosis visualized on coronary CTA conveys powerful prognostic information, incremental to that provided by clinical variables and coronary calcium scoring. Proposed markers of future plaque instability and coronary risk, such as the degree of vessel remodeling and low-attenuation plaque volume, as well as measures of CT myocardial perfusion, may further improve the prognostic value of CTA. Ultimately, studies are needed to assess whether the prognostic information provided by coronary CTA testing results in sustained changes in patient and provider behaviors that cost effectively improve patient outcomes.
冠状动脉计算机断层扫描血管造影（CTA）是一种越来越常用的、高度准确的非侵入性诊断冠状动脉疾病的方法。越来越多的数据令人信服地证明，冠状动脉 CTA 上观察到的阻塞性和非阻塞性冠状动脉粥样硬化的存在、程度和位置提供了有力的预后信息，补充了临床变量和冠状动脉钙评分所提供的信息。未来斑块不稳定性和冠状动脉风险的标志物，如血管重构程度和低衰减斑块体积，以及 CT 心肌灌注测量，可能进一步提高 CTA 的预后价值。最终，需要研究来评估冠状动脉 CTA 检测结果提供的预后信息是否导致患者和提供者行为的持续改变，从而以具有成本效益的方式改善患者的预后。
