Ayoub Chadi, Scalia Isabel G, Anavekar Nandan S, Arsanjani Reza, Jokerst Clinton E, Chow Benjamin J W, Kritharides Leonard
Department of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ 85054, USA.
Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USA.
Diagnostics (Basel). 2024 Sep 23;14(18):2096. doi: 10.3390/diagnostics14182096.
Coronary CT angiography (CCTA) is now endorsed by all major cardiology guidelines for the investigation of chest pain and assessment for coronary artery disease (CAD) in appropriately selected patients. CAD is a leading cause of morbidity and mortality. There is extensive literature to support CCTA diagnostic and prognostic value both for stable and acute symptoms. It enables rapid and cost-effective rule-out of CAD, and permits quantification and characterization of coronary plaque and associated significance. In this comprehensive review, we detail the road traveled as CCTA evolved to include quantitative assessment of plaque stenosis and extent, characterization of plaque characteristics including high-risk features, functional assessment including fractional flow reserve-CT (FFR-CT), and CT perfusion techniques. The state of current guideline recommendations and clinical applications are reviewed, as well as future directions in the rapidly advancing field of CT technology, including photon counting and applications of artificial intelligence (AI).
冠状动脉CT血管造影（CCTA）现已得到所有主要心脏病学指南的认可，用于对适当选择的患者进行胸痛调查和冠状动脉疾病（CAD）评估。CAD是发病和死亡的主要原因。有大量文献支持CCTA对稳定和急性症状的诊断及预后价值。它能够快速且经济高效地排除CAD，并对冠状动脉斑块及其相关意义进行量化和特征描述。在这篇综述中，我们详细阐述了CCTA的发展历程，其已发展到包括斑块狭窄和范围的定量评估、斑块特征（包括高危特征）的描述、功能评估（包括血流储备分数CT（FFR-CT））以及CT灌注技术。本文回顾了当前指南建议和临床应用的现状，以及CT技术快速发展领域的未来方向，包括光子计数和人工智能（AI）的应用。
