Park Hyewon, Oh Yu-Whan, Lee Ki Yeol, Yong Hwan Seok, Kim Cherry, Hwang Sung Ho
J Korean Soc Radiol. 2024 Mar;85(2):297-307. doi: 10.3348/jksr.2023.0141. Epub 2024 Mar 27.
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.
冠状动脉疾病（CAD）会使动脉粥样硬化部位的血管腔变窄，增加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）是一种非侵入性成像技术，能够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CAD的诊断很有用。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）已被开发出来，以提高疑似CAD患者的干预效果。虽然CAD-RADS基于CTA，但它包括一些临界类别，仅根据CTA结果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类别且需要额外检查以决定是否进行有创冠状动脉造影的CTA结果，并讨论了适当的管理策略。
