Non-Contrast and Contrast-Enhanced Cardiac Computed Tomography Imaging in the Diagnostic and Prognostic Evaluation of Coronary Artery Disease
In recent decades, cardiac computed tomography (CT) has emerged as a powerful non-invasive tool for risk stratification, as well as the detection and characterization of coronary artery disease (CAD), which remains the main cause of morbidity and mortality in the world. Advances in technology have f...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-06-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/13/12/2074 |
| _version_ | 1827737732929028096 |
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| author | Luca Pugliese Francesca Ricci Giacomo Sica Mariano Scaglione Salvatore Masala |
| author_facet | Luca Pugliese Francesca Ricci Giacomo Sica Mariano Scaglione Salvatore Masala |
| author_sort | Luca Pugliese |
| collection | DOAJ |
| description | In recent decades, cardiac computed tomography (CT) has emerged as a powerful non-invasive tool for risk stratification, as well as the detection and characterization of coronary artery disease (CAD), which remains the main cause of morbidity and mortality in the world. Advances in technology have favored the increasing use of cardiac CT by allowing better performance with lower radiation doses. Coronary artery calcium, as assessed by non-contrast CT, is considered to be the best marker of subclinical atherosclerosis, and its use is recommended for the refinement of risk assessment in low-to-intermediate risk individuals. In addition, coronary CT angiography (CCTA) has become a gate-keeper to invasive coronary angiography (ICA) and revascularization in patients with acute chest pain by allowing the assessment not only of the extent of lumen stenosis, but also of its hemodynamic significance if combined with the measurement of fractional flow reserve or perfusion imaging. Moreover, CCTA provides a unique incremental value over functional testing and ICA by imaging the vessel wall, thus allowing the assessment of plaque burden, composition, and instability features, in addition to perivascular adipose tissue attenuation, which is a marker of vascular inflammation. There exists the potential to identify the non-obstructive lesions at high risk of progression to plaque rupture by combining all of these measures. |
| first_indexed | 2024-03-11T02:34:40Z |
| format | Article |
| id | doaj.art-5ac990c145e34117934a089abcd04f35 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-11T02:34:40Z |
| publishDate | 2023-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-5ac990c145e34117934a089abcd04f352023-11-18T10:00:43ZengMDPI AGDiagnostics2075-44182023-06-011312207410.3390/diagnostics13122074Non-Contrast and Contrast-Enhanced Cardiac Computed Tomography Imaging in the Diagnostic and Prognostic Evaluation of Coronary Artery DiseaseLuca Pugliese0Francesca Ricci1Giacomo Sica2Mariano Scaglione3Salvatore Masala4Radiology Unit, Department of Medical-Surgical Sciences and Translational Medicine, Sapienza University of Rome, Sant’Andrea University Hospital, 00189 Rome, ItalyRadiology Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, ItalyRadiology Unit, Monaldi Hospital, 80131 Napoli, ItalyRadiology Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, ItalyRadiology Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, ItalyIn recent decades, cardiac computed tomography (CT) has emerged as a powerful non-invasive tool for risk stratification, as well as the detection and characterization of coronary artery disease (CAD), which remains the main cause of morbidity and mortality in the world. Advances in technology have favored the increasing use of cardiac CT by allowing better performance with lower radiation doses. Coronary artery calcium, as assessed by non-contrast CT, is considered to be the best marker of subclinical atherosclerosis, and its use is recommended for the refinement of risk assessment in low-to-intermediate risk individuals. In addition, coronary CT angiography (CCTA) has become a gate-keeper to invasive coronary angiography (ICA) and revascularization in patients with acute chest pain by allowing the assessment not only of the extent of lumen stenosis, but also of its hemodynamic significance if combined with the measurement of fractional flow reserve or perfusion imaging. Moreover, CCTA provides a unique incremental value over functional testing and ICA by imaging the vessel wall, thus allowing the assessment of plaque burden, composition, and instability features, in addition to perivascular adipose tissue attenuation, which is a marker of vascular inflammation. There exists the potential to identify the non-obstructive lesions at high risk of progression to plaque rupture by combining all of these measures.https://www.mdpi.com/2075-4418/13/12/2074cardiac computed tomographycoronary computed tomography angiographycoronary artery calciumepicardial adipose tissuecoronary stenosismyocardial ischemia |
| spellingShingle | Luca Pugliese Francesca Ricci Giacomo Sica Mariano Scaglione Salvatore Masala Non-Contrast and Contrast-Enhanced Cardiac Computed Tomography Imaging in the Diagnostic and Prognostic Evaluation of Coronary Artery Disease Diagnostics cardiac computed tomography coronary computed tomography angiography coronary artery calcium epicardial adipose tissue coronary stenosis myocardial ischemia |
| title | Non-Contrast and Contrast-Enhanced Cardiac Computed Tomography Imaging in the Diagnostic and Prognostic Evaluation of Coronary Artery Disease |
| title_full | Non-Contrast and Contrast-Enhanced Cardiac Computed Tomography Imaging in the Diagnostic and Prognostic Evaluation of Coronary Artery Disease |
| title_fullStr | Non-Contrast and Contrast-Enhanced Cardiac Computed Tomography Imaging in the Diagnostic and Prognostic Evaluation of Coronary Artery Disease |
| title_full_unstemmed | Non-Contrast and Contrast-Enhanced Cardiac Computed Tomography Imaging in the Diagnostic and Prognostic Evaluation of Coronary Artery Disease |
| title_short | Non-Contrast and Contrast-Enhanced Cardiac Computed Tomography Imaging in the Diagnostic and Prognostic Evaluation of Coronary Artery Disease |
| title_sort | non contrast and contrast enhanced cardiac computed tomography imaging in the diagnostic and prognostic evaluation of coronary artery disease |
| topic | cardiac computed tomography coronary computed tomography angiography coronary artery calcium epicardial adipose tissue coronary stenosis myocardial ischemia |
| url | https://www.mdpi.com/2075-4418/13/12/2074 |
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