I. Density of the lesion
The normal canal wall does not show; the lumen margin is regular; the lumen thickness is uniform; there are no obvious signs such as lumen narrowing and dilatation.
1.Calcified plaque.
Density: plain scan: >130Hu
Enhancement: >350Hu
Morphology: punctate calcification, striated calcification, diffuse irregular calcification.
2. Non-calcified plaques.
Including soft plaques and fibrous plaques showing thickening of the canal wall.
3.Mixed plaque: canal wall thickening + canal wall calcification
II. Morphology of lesions
1. Centripetal stenosis: The centerline of coronary artery lumen is the center of uniform inward narrowing.
2.Eccentric stenosis: Uneven narrowing of the plaque toward the centerline of the coronary artery lumen or protrusion into the lumen from the side of the centerline, resulting in stenosis.
3, occlusive lesion: refers to coronary atherosclerosis or with acute or subacute thrombosis, resulting in complete occlusion of the lumen and interruption of blood flow. Distal contrast filling is seen, but the density is faint and the lumen is small.
4.Vascular remodeling: Atherosclerotic lesions lead to changes in the coronary vessel wall structure and intravascular lumen.
Positive remodeling: the vessel wall is thickened, atherosclerotic plaque exists, but the lumen narrowing is not obvious.
Negative remodeling: vessel wall thickening, presence of atherosclerotic plaques, and luminal narrowing.
5.Dilated lesion: refers to acquired or congenital factors that destroy the structure of the coronary wall and cause outward dilatational changes in the vessel wall.
Aneurysmal dilatation: vessel diameter >7mm or more than 50% of the diameter of the adjacent arterial segment.
Coronary aneurysm: limited dilatation <7mm in length.
Coronary artery dilatation: diffuse dilatation >7mm in length.
Coronary artery dilatation: diffuse dilatation involving 2/3 of the entire length of the coronary artery.
Male > female; mostly in the proximal segment of the main coronary branch.
Elderly: atherosclerosis.
Children and adolescents: arteritis (Kawasaki disease), congenital coronary artery fistula.
Third, the extent of lesions.
1.Limited stenosis: length less than 10mm.
2.Segmental stenosis: 10-20mm.
3.Diffuse stenosis: >20mm