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Review
. 2023 Dec 11;12(24):7615.
doi: 10.3390/jcm12247615.

CT Coronary Angiography: Technical Approach and Atherosclerotic Plaque Characterization

Serena Dell'Aversana  1 , Raffaele Ascione  2 , Raffaella Antonia Vitale  2 , Fabrizia Cavaliere  2 , Piercarmine Porcaro  2 , Luigi Basile  2 , Giovanni Napolitano  3 , Marco Boccalatte  4 , Gerolamo Sibilio  4 , Giovanni Esposito  2 , Anna Franzone  2 , Giuseppe Di Costanzo  1 , Giuseppe Muscogiuri  5 , Sandro Sironi  5   6 , Renato Cuocolo  7 , Enrico Cavaglià  1 , Andrea Ponsiglione  2 , Massimo Imbriaco  2
Affiliations
Review

CT Coronary Angiography: Technical Approach and Atherosclerotic Plaque Characterization

Serena Dell'Aversana et al. J Clin Med. .

Abstract

Coronary computed tomography angiography (CCTA) currently represents a robust imaging technique for the detection, quantification and characterization of coronary atherosclerosis. However, CCTA remains a challenging task requiring both high spatial and temporal resolution to provide motion-free images of the coronary arteries. Several CCTA features, such as low attenuation, positive remodeling, spotty calcification, napkin-ring and high pericoronary fat attenuation index have been proved as associated to high-risk plaques. This review aims to explore the role of CCTA in the characterization of high-risk atherosclerotic plaque and the recent advancements in CCTA technologies with a focus on radiomics plaque analysis.

Keywords: CCTA; atherosclerosis; prognosis; radiomics.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Exemplificative image of the atherosclerotic process.
Figure 2
Figure 2
ECG-gating approaches for CCTA.
Figure 3
Figure 3
Flowchart proposal for CCTA protocol.
Figure 4
Figure 4
CCTA and coronary angiography of a 74-year-old male patient showing: Two plaques in the proximal segment of RCA with respective napkin-ring sign (green arrowhead, (a–d)) causing significant stenosis (>70%) and spotty calcification (red arrowhead, (b–d)) producing mild stenosis. Calcified plaque in the proximal segment of LAD causing mild stenosis (yellow arrowhead (e,f)). Positive remodeling and low attenuation plaque in the proximal segment of CX (blue arrowhead, (g–i)). The corresponding coronary angiography images are shown in figure (c–h).
See this image and copyright information in PMC

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