Coronary CT Imaging of Atherosclerotic Plaque

Patient Guideline Summary

Publication Date: November 8, 2020
Last Updated: March 3, 2023

Objective

Objective

This patient summary means to discuss key recommendations from the Society of Cardiovascular Computed Tomography and the North American Society of Cardiovascular Imaging for coronary CT imaging of atherosclerotic plaque.

Overview

Overview

  • Coronary arteries supply the heart muscle with blood. When they are diseased, they cause heart attacks.
  • The most common cause of disease in coronary arteries is arteriosclerosis (hardening of the arteries).
    • Arteriosclerosis causes plaques to form in the lining of arteries, narrowing and eventually occluding them.
    • Calcium presence in plaque is an important indication of how high the risk is for that plaque to cause a heart attack.
  • Coronary computed tomographic angiography (imaging blood vessels) (CCTA) is an excellent method to evaluate the condition of the coronary arteries.
  • This patient summary focuses on standards for reporting the findings from a coronary CT test of the extent of atherosclerotic disease.

Diagnosis

Diagnosis

  • The full report of CCTA should include:
    • Presence of high-risk plaque – how much, how dangerous – according to a standardized scoring system Coronary Artery Disease - Reporting and Data System (CAD-RADS)
    • Segment involvement score (SIS) that characterized each plaque
    • Calcium content of plaque - the Coronary Artery Calcium (CAC) score
    • The overall amount or extent of atherosclerotic plaque

Abbreviations

  • CAC: Coronary Artery Calcium
  • CAD-RADS: Coronary Artery Disease - Reporting And Data System
  • CCTA: Coronary/cardiac Computed Tomography Angiography
  • SIS: Segment Involvement Score

Source Citation

Shaw LJ, Blankstein R, Bax JJ, Ferencik M, Bittencourt MS, Min JK, Berman DS, Leipsic J, Villines TC, Dey D, Al'Aref S, Williams MC, Lin F, Baskaran L, Litt H, Litmanovich D, Cury R, Gianni U, van den Hoogen I, R van Rosendael A, Budoff M, Chang HJ, E Hecht H, Feuchtner G, Ahmadi A, Ghoshajra BB, Newby D, Chandrashekhar YS, Narula J. Society of Cardiovascular Computed Tomography / North American Society of Cardiovascular Imaging - Expert Consensus Document on Coronary CT Imaging of Atherosclerotic Plaque. J Cardiovasc Comput Tomogr. 2021 Mar-Apr;15(2):93-109. doi: 10.1016/j.jcct.2020.11.002. Epub 2020 Nov 9. PMID: 33303383.

Disclaimer

The information in this patient summary should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.