阿卜杜萨拉木·图尔迪麦麦提,马翔

• 1:新疆医科大学第一临床医学院
• 2:新疆医科大学第一附属医院心脏中心

摘要(Abstract)：

随着冠状动脉CT血管造影（CCTA）、腔内影像学、分子影像及人工智能等技术的发展，高危冠状动脉粥样硬化斑块的在体识别能力不断提高。高危斑块的内涵已由传统薄纤维帽斑块（TCFA）的单一形态学评价，逐渐拓展至涵盖斑块负荷、组织成分、生物学活性、局部血流动力学及患者危险背景的综合评估。CCTA、光学相干断层成像（OCT）、血管内超声（IVUS）联合近红外光谱成像（NIRS）及~(18)F-氟化钠正电子发射断层扫描（~(18)F-Na F PET）/CT等多模态影像技术，从斑块宏观结构、微观形态、组织成分及生物学活性等不同层面丰富了高危斑块的在体表征；人工智能及影像组学则进一步促进了复杂影像信息的自动化定量分析与多维整合。现有证据表明，高危斑块识别可为非阻塞性冠心病及糖尿病等特殊人群的风险分层提供增量信息，并在疗效监测及个体化干预决策中显示出潜在价值。然而，不同影像征象的定义、测量方法及判定阈值仍存在异质性，人工智能模型的泛化能力及影像指导治疗改善主要不良心血管事件等临床终点的证据亦有待进一步完善。本文综述多模态影像与人工智能在高危冠状动脉粥样硬化斑块在体识别中的研究进展，并探讨其临床转化价值及未来挑战。

关键词(KeyWords)： 冠状动脉疾病;高危斑块;光学相干断层成像;人工智能;冠状动脉CT血管造影

Abstract:

Keywords:

基金项目(Foundation): 国家级重大科研项目培育项目（XYD2024ZX03）;; 新疆生产建设兵团创新团队项目（2025DB018）

作者(Author): 阿卜杜萨拉木·图尔迪麦麦提,马翔

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