2024+ASCI共识声明:冠状动脉狭窄和斑块的CT血管造影评估.pdf
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1、331Copyright 2024 The Korean Society of Radiology2024 Consensus Statement on Coronary Stenosis and Plaque Evaluation in CT Angiography From the Asian Society of Cardiovascular Imaging-Practical Tutorial(ASCI-PT)Cherry Kim1*,Chul Hwan Park2*,Bae Young Lee3,Chan Ho Park4,Eun-Ju Kang5,Hyun Jung Koo6,Ka
2、kuya Kitagawa7,Min Jae Cha8,Rungroj Krittayaphong9,Sang Il Choi10,Hwan Seok Yong11,Sung Min Ko12,Sung Mok Kim13,Sung Ho Hwang14,Nguyen Ngoc Trang15,Whal Lee16,Young Jin Kim17,Jongmin Lee18,Dong Hyun Yang61Department of Radiology,Korea University Ansan Hospital,Ansan,Republic of Korea 2Department of
3、Radiology and Research Institute of Radiological Science,Gangnam Severance Hospital,Yonsei University College of Medicine,Seoul,Republic of Korea 3Department of Radiology,Eunpyeong St.Marys Hospital,College of Medicine,The Catholic University of Korea,Seoul,Republic of Korea 4Department of Radiology
4、,Soonchunhyang University Cheonan Hospital,Cheonan,Republic of Korea 5Department of Radiology,College of Medicine,Dong-A University,Busan,Republic of Korea 6Department of Radiology and Research Institute of Radiology,Cardiac Imaging Center,Asan Medical Center,University of Ulsan College of Medicine,
5、Seoul,Republic of Korea 7Department of Radiology,Mie University Graduate School of Medicine,Tsu,Japan 8Department of Radiology,Chung-Ang University Hospital,Seoul,Republic of Korea 9Division of Cardiology,Department of Medicine,Siriraj Hospital,Mahidol University,Bangkok,Thailand 10Department of Rad
6、iology,Seoul University Bundang Hospital,Seongnam,Republic of Korea 11Department of Radiology,Korea University Guro Hospital,Seoul,Republic of Korea 12Department of Radiology,Yonsei University Wonju College of Medicine,Wonju Severance Christian Hospital,Wonju,Republic of Korea 13Department of Radiol
7、ogy,Samsung Medical Center,Sungkyunkwan University School of Medicine,Seoul,Republic of Korea 14Department of Radiology,Korea University Anam Hospital,Seoul,Republic of Korea 15Center of Radiology,Bachmai University Hospital,Hanoi,Vietnam 16Department of Radiology,Seoul National University Hospital,
8、Seoul,Republic of Korea 17Department of Radiology and Research Institute of Radiological Science,Severance Hospital,Yonsei University College of Medicine,Seoul,Republic of Korea 18Department of Radiology,Kyungpook National University Hospital,Daegu,Republic of KoreaThe Asian Society of Cardiovascula
9、r Imaging-Practical Tutorial(ASCI-PT)is an instructional initiative of the ASCI School designed to enhance educational standards.In 2021,the ASCI-PT was convened with the goal of formulating a consensus statement on the assessment of coronary stenosis and coronary plaque using coronary CT angiograph
10、y(CCTA).Nineteen experts from four countries conducted thorough reviews of current guidelines and deliberated on eight key issues to refine the process and improve the clarity of reporting CCTA findings.The experts engaged in both online and on-site sessions to establish a unified agreement.This doc
11、ument presents a summary of the ASCI-PT 2021 deliberations and offers a comprehensive consensus statement on the evaluation of coronary stenosis and coronary plaque in CCTA.Keywords:Coronary CT angiography;Coronary artery stenosis;Coronary artery plaque;Consensus developmentKorean J Radiol 2024;25(4
12、):331-342eISSN 2005-8330https:/doi.org/10.3348/kjr.2024.0112Recommendation and GuidelineReceived:January 30,2024 Accepted:January 31,2024This article is being published jointly in the Korean Journal of Radiology and Cardiovascular Imaging Asia.*These authors contributed equally to this work.Correspo
13、nding author:Dong Hyun Yang,MD,Department of Radiology and Research Institute of Radiology,Cardiac Imaging Center,Asan Medical Center,University of Ulsan College of Medicine,88 Olympic-ro 43-gil,Songpa-gu,Seoul 05505,Republic of Korea E-mail:This is an Open Access article distributed under the terms
14、 of the Creative Commons Attribution Non-Commercial License(https:/creativecommons.org/licenses/by-nc/4.0)which permits unrestricted non-commercial use,distribution,and reproduction in any medium,provided the original work is properly cited.332Kim et al.https:/doi.org/10.3348/kjr.2024.0112kjronline.
15、org(Supplementary Table 1).To gauge the panelists experiences and practice patterns and to identify key discussion points for the consensus session,two online pre-meeting surveys were executed.The panel selection,pre-meeting survey preparation,and analysis of results were overseen by the ASCI-PTs di
16、rector,Dong Hyun Yang,alongside two co-directors,Chul Hwan Park and Cherry Kim.The first survey sought details on the panelists clinical experience,CCTA imaging reconstruction protocols,interpretation methodologies,and reporting protocols(Supplementary Table 2).To accurately reflect current practice
17、s,radiological report samples from each participating hospital were collected.The subsequent survey posed queries regarding issues that,despite being partially addressed in existing guidelines,could lead to uncertainties in practical interpretation.This survey comprised 34 questions that spanned sev
18、eral core topics,including the assignment of coronary segments,assessment of high-risk plaque(HRP)morphologies,and the evaluation of plaque length,composition,and stenosis degree(Supplementary Tables 3-6).Analysis of the initial survey revealed that the experts,on average,possessed 15.1 5.9 years of
19、 experience post-board certification.Among the respondents,4(21.1%)interpreted in excess of 500 CCTA scans monthly,6(31.6%)between 200500,and 5(26.3%)between 100200 scans,and 4(21.1%)less than 100 scans.It was noted that 73.7%of the panelists evaluated coronary stenosis using imaging workstations.Ex
20、amination of the hospital reports showed universal mention of plaque composition,yet only 31.6%specifically identified HRP,and 31.6%reported routinely employing the CAD-RADS.The findings from the second survey were initially processed by the director and co-directors and disclosed at the in-person c
21、onference.The two-day meetings schedule is detailed in Supplementary Table 7.Day one involved panelists assessing the results of the pre-meeting surveys,performing literature reviews pertinent to each topic under discussion,and collectively examining cases pertaining to these topics using the availa
22、ble imaging workstations.Following this,eight topics identified as clinically pertinent and exhibiting variability among panel opinions were selected for the final consensus discussion,as listed in Table 1.During the second day,online panelists joined to review the outcomes of the pre-meeting survey
23、s and the preliminary consensus draft.Each point was deliberated in the morning session,with both online and on-site panelists contributing to the voting process.Consensus was defined by the level INTRODUCTIONCoronary CT angiography(CCTA)has emerged as a prominent non-invasive cardiac imaging techni
24、que and has rapidly gained widespread acceptance 1,2.The 2021 American Heart Association guidelines for chest pain management now recognize CCTA as a primary diagnostic tool,solidifying its critical role in evaluating potential coronary artery disease(CAD)3.Consequently,its use is anticipated to ris
25、e among patients with suspected CAD 3-5.Interpretation of CCTA has largely been guided by the Society of Cardiovascular Computed Tomography(SCCT)guidelines 6,7,and the Coronary Artery Disease Reporting and Data System(CAD-RADS)also offers a detailed framework for interpretation 8-10.However,ambiguit
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- asci 共识 共鸣 声明 冠状动脉 狭窄 狭小 以及 ct 血管 造影 评估
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