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Grading scale for stenosis severity, plaque burden, and ischemia

Grading scale for stenosis severity, plaque burden, and ischemia
Degree of luminal diameter stenosis Terminology
0% No visible stenosis
1 to 24% Minimal stenosis
25 to 49% Mild stenosis
50 to 69% Moderate stenosis
70 to 99% Severe stenosis
100% Occluded
Grading scale for plaque burden:
Terminology Overall plaque burden
P1 Mild amount of plaque
P2 Moderate amount of plaque
P3 Severe amount of plaque
P4 Extensive amount of plaque
Grading scale for ischemia detection:
Terminology Meaning
Modifier I Indicates that CT ischemia test was performed either with CT-FFR or myocardial CTP
I+ Indicates that CT-FFR or CTP demonstrates lesion-specific ischemia or reversible perfusion defect
I– Indicates that CT-FFR or CTP is negative for lesion specific ischemia or reversible ischemia*
Indicates that CT-FFR or CTP is borderline

CT: computed tomography; CT-FFR: CT fractional flow reserve; CTP: CT perfusion.

* Patients with prior myocardial infarction and fixed perfusion defects without evidence of myocardial ischemia by CTP would be classified as I–. The presence of myocardial infarction should be documented in the impression of the report.
Used with permission of Radiological Society of North America, from: Cury RC, Leipsic J, Abbara S, et al. CAD-RADS™ 2.0 – 2022 Coronary Artery Disease – Reporting and Data System: An expert consensus document of the Society of Cardiovascular Computed Tomography (SCCT), the American College of Cardiology (ACC), the American College of Radiology (ACR) and the North America Society of Cardiovascular Imaging (NASCI). Radiol Cardiothorac Imaging 2022; 4:e220183. Copyright © 2021 Radiological Society of America; permission conveyed through Copyright Clearance Center, Inc.
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