Journal of the Korean Society of Radiology (Mar 2024)

Visualization of Borderline Coronary Artery Lesions by CT Angiography and Coronary Artery Disease Reporting and Data System

  • Hyewon Park,
  • Yu-Whan Oh,
  • Ki Yeol Lee,
  • Hwan Seok Yong,
  • Cherry Kim,
  • Sung Ho Hwang

DOI
https://doi.org/10.3348/jksr.2023.0141
Journal volume & issue
Vol. 85, no. 2
pp. 297 – 307

Abstract

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Coronary artery disease (CAD) narrows vessel lumens at the sites of atherosclerosis, increasing the risk of myocardial ischemia or infarction. Early and accurate diagnosis of CAD is crucial to significantly improve prognosis and management. CT angiography (CTA) is a noninvasive imaging technique that enables assessment of vascular structure and stenosis with high resolution and contrast. Coronary CTA is useful in the diagnosis of CAD. Recently, the CAD-reporting and data system (CAD-RADS), a diagnostic classification system based on coronary CTA, has been developed to improve intervention efficacy in patients suspected of CAD. While the CADRAD is based on CTA, it includes borderline categories where interpreting the coronary artery status solely based on CTA findings may be challenging. This review introduces CTA findings that fall within the CAD-RADS categories that necessitate additional tests to decide to perform invasive coronary angiography and discusses appropriate management strategies.

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