Kang Doo Kyoung
J Korean Soc Radiol. 2024 Mar;85(2):270-296. doi: 10.3348/jksr.2023.0134. Epub 2024 Mar 27.
Coronary CT angiography (CCTA) is recognized for its role as a gatekeeper for invasive coronary angiography in patients suspected of coronary artery disease because it can detect significant coronary stenosis with high accuracy. However, heavy plaque in the coronary artery makes it difficult to visualize the lumen, which can lead to errors in the interpretation of the CCTA results. This is primarily due to the limited spatial resolution of CT scanners, resulting in blooming artifacts caused by calcium. However, coronary stenosis with high calcium scores often requires evaluation using CCTA. Technological methods to overcome these limitations include the introduction of high-resolution CT scanners, the development of reconstruction techniques, and the subtraction technique. Methods to improve reading ability, such as the setting of appropriate window width and height, and evaluation of the position of calcified plaque and residual visibility of the lumen in cross-sectional images, are also recommended.
冠状动脉CT血管造影（CCTA）因其在疑似冠状动脉疾病患者中作为侵入性冠状动脉造影的把关作用而得到认可，因为它能够高精度地检测出显著的冠状动脉狭窄。然而，冠状动脉内的重度斑块会使管腔难以显影，这可能导致CCTA结果解读出现误差。这主要是由于CT扫描仪的空间分辨率有限，导致钙引起的 blooming 伪影。然而，高钙评分的冠状动脉狭窄通常需要使用CCTA进行评估。克服这些限制的技术方法包括引入高分辨率CT扫描仪、开发重建技术和减法技术。还建议采用提高阅片能力的方法，如设置合适的窗宽和窗高，以及在横断面图像中评估钙化斑块的位置和管腔的残余可视性。
