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CAD-RADS 2.0 - 2022 coronary artery disease-reporting and data system: an expert consensus
document of the society of cardiovascular computed tomography (SCCT), the American
college of cardiology (ACC), the American college of radiology (ACR), and the north
America society of cardiovascular imaging (NASCI).
in which the plaque burden sub-classification was recommended by SCCT as a part of
the diagnosis report for the first time. Indeed, the information about the qualitative
and quantitative of plaque burden on CCTA has strong association with heart adverse
events
Society of cardiovascular computed tomography/north American society of cardiovascular
imaging - expert consensus document on coronary CT imaging of atherosclerotic plaque.
But, when we try to write a report with reference to the guideline, we meet a puzzle
that “Visual" (observation) is obviously a vague concept, which will be resulting
in phenomenon that for same plaque lesson the same doctor give different conclusion
before and after and different doctors at the same time. And also, the concepts of
“Visual” seems cannot cover the whole situation clinically (refer examples Fig. 1).
Fig. 1Upper panel. Female, 65y/o, known CAD for 17 years with hypertension of 3 years and
stable angina about 2 years. The CCTA (left to right indicating LAD, LCX and RCA).showed
severe non-calcified and calcified plaque burden on multi-segments of three coronary
arteries as P 4 refer to the figure in the text, but CAC 897 as P3. Lower panel. Man,
51y/o, heavy smoker with history of diabetes mellitus of more than 30 years, presented
with unstable angina for an week. The CCTA (left to right indicating LAD, LCX and
RCA) showed more severe dominance calcified plaque than figure 1 on multi-segments
of three coronary arteries as P 4 refer to the figure in the text. The calcified plaque
scans showed CAC=2890. The two cases showed apparently different plaque characteristics
and plaque burden but both can be classified as P4 grade, the different clinical importance
for the same grade should be concerned and discussed. CAD: coronary artery disease;
CAC: Coronary calcification score; CCTA: coronary computed tomography angiography;
LAD: left anterior descending; LCX: left circumflex; RCA: right coronary artery.
CAD-RADS 2.0 - 2022 coronary artery disease-reporting and data system: an expert consensus document of the society of cardiovascular computed tomography (SCCT), the American college of cardiology (ACC), the American college of radiology (ACR), and the north America society of cardiovascular imaging (NASCI).
Society of cardiovascular computed tomography/north American society of cardiovascular imaging - expert consensus document on coronary CT imaging of atherosclerotic plaque.
