Society of Cardiovascular Computed Tomography / North American Society of Cardiovascular Imaging - Expert Consensus Document on Coronary CT Imaging of Atherosclerotic Plaque

被引：161

作者：

Shaw, Leslee J. ^{[1
]}

Blankstein, Ron ^{[2
]}

Bax, Jeroen J. ^{[3
]}

Ferencik, Maros ^{[4
]}

Bittencourt, Marcio Sommer ^{[5
]}

Min, James K. ^{[1
,6
]}

Berman, Daniel S. ^{[7
]}

Leipsic, Jonathon ^{[8
]}

Villines, Todd C. ^{[9
]}

Dey, Damini ^{[10
]}

Al'Aref, Subhi ^{[1
]}

Williams, Michelle C. ^{[11
]}

Lin, Fay ^{[1
]}

Baskaran, Lohendran ^{[1
]}

Litt, Harold ^{[12
]}

Litmanovich, Diana ^{[13
]}

Cury, Ricardo ^{[14
,15
]}

Gianni, Umberto ^{[1
]}

van den Hoogen, Inge ^{[16
]}

van Rosendael, Alexander R. ^{[1
]}

Budoff, Matthew ^{[17
]}

Chang, Hyuk-Jae ^{[18
]}

Hecht, Harvey E. ^{[19
]}

Feuchtner, Gudrun ^{[20
]}

Ahmadi, Amir ^{[19
]}

Ghoshajra, Brian B. ^{[21
]}

Newby, David ^{[11
]}

Chandrashekhar, Y. S. ^{[22
]}

Narula, Jagat ^{[19
]}

机构：

[1] Weill Cornell Sch Med, New York, NY USA

[2] Harvard Med Sch, Brigham & Womens Hosp, Boston, MA 02115 USA

[3] Leiden Univ, Leiden, Netherlands

[4] Oregon Hlth & Sci Univ, Portland, OR 97201 USA

[5] Univ Sao Paulo, Sao Paulo, Brazil

[6] Cleerly Inc, New York, NY USA

[7] Cedars Sinai Med Ctr, Cedars Sinai Heart Inst, Los Angeles, CA 90048 USA

[8] Univ British Columbia, Vancouver, BC, Canada

[9] Univ Virginia, Charlottesville, VA USA

[10] Cedars Sinai Med Ctr, Los Angeles, CA 90048 USA

[11] Univ Edinburgh, Edinburgh, Midlothian, Scotland

[12] Univ Penn, Perelman Sch Med, Philadelphia, PA 19104 USA

[13] Harvard Med Sch, Beth Israel Deaconess Med Ctr, Boston, MA 02115 USA

[14] Miami Cardiac & Vasc Inst, Miami, FL USA

[15] Baptist Hlth South Florida, Miami, FL USA

[16] Leiden Univ, Med Ctr, Leiden, Netherlands

[17] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA

[18] Yonsei Univ, Seoul, South Korea

[19] Mt Sinai Sch Med, New York, NY USA

[20] Innsbruck Med Univ, Innsbruck, Austria

[21] Massachusetts Gen Hosp, Boston, MA 02114 USA

[22] Univ Minnesota, Minneapolis, MN USA

来源：

JOURNAL OF CARDIOVASCULAR COMPUTED TOMOGRAPHY | 2021年 / 15卷 / 02期

关键词：

Atherosclerotic plaque; Prognosis; Acute coronary syndrome; High risk plaque; Prevention; INCREMENTAL PROGNOSTIC VALUE; NAPKIN-RING SIGN; ACUTE CHEST-PAIN; FRACTIONAL FLOW RESERVE; LOW-ATTENUATION PLAQUE; ALL-CAUSE MORTALITY; DUAL-SOURCE CT; ARTERY-DISEASE; INTRAVASCULAR ULTRASOUND; VIRTUAL HISTOLOGY;

D O I：

10.1016/j.jcct.2020.11.002

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Coronary computed tomographic angiography (CCTA) provides a wealth of clinically meaningful information beyond anatomic stenosis alone, including the presence or absence of nonobstructive atherosclerosis and high-risk plaque features as precursors for incident coronary events. There is, however, no uniform agreement on how to identify and quantify these features or their use in evidence-based clinical decision-making. This statement from the Society of Cardiovascular Computed Tomography and North American Society of Cardiovascular Imaging addresses this gap and provides a comprehensive review of the available evidence on imaging of coronary atherosclerosis. In this statement, we provide standardized definitions for high-risk plaque (HRP) features and distill the evidence on the effectiveness of risk stratification into usable practice points. This statement outlines how this information should be communicated to referring physicians and patients by identifying critical elements to include in a structured CCTA report - the presence and severity of atherosclerotic plaque (descriptive statements, CAD-RADS (TM) categories), the segment involvement score, HRP features (e.g., low attenuation plaque, positive remodeling), and the coronary artery calcium score (when performed). Rigorous documentation of atherosclerosis on CCTA provides a vital opportunity to make recommendations for preventive care and to initiate and guide an effective care strategy for at-risk patients. (C) 2020 Published by Elsevier Inc. on behalf of Society of Cardiovascular Computed Tomography.

引用

页码：93 / 109

页数：17

共 126 条

[31] Coronary calcium as a predictor of coronary events in four racial or ethnic groups [J].