Cardiac Computed Tomography: Assessment of Coronary Inflammation and Other Plaque Features

Area of Science:

• Cardiovascular Imaging
• Radiology
• Interventional Cardiology

Background:

• Unstable coronary plaques are a primary cause of acute coronary syndromes.
• Advances in medical imaging and understanding of atherosclerosis have positioned cardiac computed tomography (CCT) as a crucial diagnostic tool.
• CCT is vital for detecting vulnerable plaques and patients at risk.

Purpose of the Study:

• To review the current role of CCT in assessing coronary atherosclerosis.
• To highlight CCT's capabilities in detecting high-risk plaque features and assessing hemodynamic significance.
• To discuss CCT's utility in quantifying coronary inflammation and its prognostic implications.

Main Methods:

• Noninvasive assessment of coronary plaque burden (qualitative and quantitative).
• Detection of high-risk morphological plaque features.
• Evaluation of hemodynamic significance of coronary lesions.
• Quantification of coronary inflammatory burden via perivascular fat analysis.

Main Results:

• CCT provides comprehensive structural and functional information on coronary atherosclerosis.
• It enables the detection of vulnerable plaques and assessment of patient risk.
• Advanced techniques like machine learning and CFD modeling enhance CCT capabilities.

Conclusions:

• Cardiac computed tomography is a powerful, noninvasive tool for diagnosing and assessing coronary artery disease.
• It offers significant diagnostic and prognostic value in managing patients with suspected or known coronary atherosclerosis.
• CCT serves as both a clinical and research tool, advancing our understanding and management of vulnerable plaques.