de Araújo Gonçalves Pedro, Hideo-Kajita Alexandre, Garcia-Garcia Hector Manuel
Department of Cardiology and Radiology, Hospital da Luz, Lisbon, Portugal.
Department of Cardiology, Hospital de Santa Cruz - Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal.
Cardiovasc Diagn Ther. 2017 Apr;7(2):219-226. doi: 10.21037/cdt.2017.04.09.
Coronary CT angiography (CCTA) is mainly regarded as a gatekeeper for invasive coronary angiography, in face of its widely recognized value to noninvasively rule out significant coronary stenosis. Nevertheless, it is also increasingly recognized that this noninvasive modality can depict several atherosclerotic plaque features and quantify total coronary plaque burden. This opens a new field for cardiac CT, since these atherosclerotic features beyond stenosis severity have been correlated with the degree of functional significance, and are the focus of the present manuscript. Although recently acknowledged and documented in CCTA studies, the relation between plaque burden and functional significance has been previously described using several intracoronary imaging modalities, which are also reviewed in the manuscript, to help put in perspective the relation between anatomy and function in coronary artery disease.
冠状动脉CT血管造影（CCTA）主要被视为侵入性冠状动脉造影的把关手段，鉴于其在无创排除显著冠状动脉狭窄方面的价值已得到广泛认可。然而，人们也越来越认识到，这种无创检查方式能够描绘多种动脉粥样硬化斑块特征，并量化冠状动脉总斑块负荷。这为心脏CT开辟了一个新领域，因为这些狭窄严重程度之外的动脉粥样硬化特征已与功能意义程度相关联，而这正是本文的重点。尽管最近在CCTA研究中得到了认可和记录，但斑块负荷与功能意义之间的关系此前已通过多种冠状动脉内成像方式进行了描述，本文也对这些成像方式进行了综述，以帮助正确看待冠状动脉疾病中解剖结构与功能之间的关系。
