[Coronary CT: from anatomy to physiology].

Abstract

Coronary CT is pivotal in diagnosing coronary artery disease, addressing epicardial stenosis, vulnerable plaques, and microvascular dysfunction. Technological and AI advancements enable simultaneous anatomical and physiological evaluation. Stenosis assessment now integrates ischemia evaluation and therapeutic planning. Vulnerable plaques are analyzed through atheroma burden, inflammation, and wall shear stress, aiding in predicting major cardiac events. Microvascular dysfunction is assessed via myocardial perfusion imaging. As an essential tool for precision medicine, coronary CT offers a comprehensive approach to this multifaceted disease, enhancing diagnosis, risk stratification, and tailored management.