الفهرس 
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Abstract
In recent decades, multi-slice coronary CT angiography has become one of the hot spots in cardiovascular imaging technology. This method has been applied for evaluating coronary artery stenosis, and was proposed as a potential alternative procedure for invasive coronary angiography. Coronary CT angiography is unique in its ability to non-invasively diagnose coronary artery disease and to accurately detect significant stenosis plus it is a quick, relatively simple and quick procedure that can be performed within 10 to 20 minutes. CAD-RADS might provide a standardized tool for data collection, producing a uniform way to report the findings of coronary computed tomography angiography (coronary CTA) to facilitate communication of test results to referring physicians along with suggestions for subsequent patient management. The Coronary Artery Disease Reporting and Data System (CADRADS) classifies the patients based on the highest grade of coronary artery stenosis on CCT, ranging from CAD-RADS 0 to CAD-RADS 5. The lowest score, CAD-RADS 0, represents no plaque or stenosis, and the highest, CAD-RADS 5, signifies total occlusion in at least one coronary vessel. The updated version of CAD-RADS classification incorporates the designation “P” with categories ranging from P1 to P4 to categorize the overall amount of plaque as mild, moderate, severe or extensive on a per patient basis. Modifiers can also be used to report findings on coronary CTA with CAD-RADS. Modifiers in the CAD-RADS classification system include non-diagnostic (N), stent (S), graft (G), High-risk plaque (HRP), ischemia (I) and exception (E). The aim of the study was to evaluate CAD-RADS as standardized reporting language for better communication between radiologist and clinicians to assess its impact on patient’ management & for risk factor stratifications. The prospective study was conducted at new Educational Hospital, Radiodiagnosis and Medical Imaging Department, Tanta University from November 2021 to November 2023. We enrolled 146 patients in this study: 68 (46.6%) of were males while 78 (53.4%) were females with age ranged from 18 to 75 years with a mean of 52.9 ± 10.64 years. All the patients were subjected to detailed history taking, clinical examination, laboratory investigations and radiological examination by Multislice CT angiography for evaluation of the coronary arteries. Cases are classified according to CAD-RADS categories based as follow: there were 17 cases were CAD RAD 0 (11.3%), 22 cases were CAD RAD 1(14.7 % ), 28 cases were CAD RAD 2 (18.7%), 34 cases were CAD RAD3 (22.7%), 34 cases were CAD RAD4 (22.7%), 11 cases were CAD RAD5 (7.3%) and 4 cases were CAD RAD N (2.6%). The most frequent modifier was modifier E found in 31 cases (21.1 %) followed by 17 cases with modifier HRP (11.6 %), 12 cases with modifier G (8.2%), 10 cases with modifier S 7.5%, and finally 9 cases with modifier N (6.2 %). The results were validated against short duration follow-up for cardiological recommendations as invasive coronary angiography (ICA) for assessment of CAD RAD accuracy. Our main findings were as follow: 1. Significant relation between CAD-RAD categories and common risk factors as age, hypertension, DM, hyperlipidemia and smoking. 2. There was a positive and significant relation between right coronary dominance and CAD-RAD categories (p= 0.002) 3. Significant difference of coronary artery calcium score was found between CAD RAD categories (p<0.001) 4. Significant relation between plaque burden and CAD RAD categories (P<0.001). 5. Strong relationship between high-risk plaque features and CAD-RADS categories (p=0.034). 6. Significant difference between modifier S and CAD RAD categories (p=0.01). 7. Significant relation with CAD severity as classified by CAD RAD categories and CABG (P<0.001). 8. 73 cases (50%) had abnormal cardiac finding and extra cardiac findings were found in cases (50%). 9. Significant strong positive relation between CAD RAD and invasive coronary angiography as gold standard reference (P = <0.001) 10. Statistically significant difference between the treatment (P<0.001) recommendation by CAD RAD and cardiological recommendation on follow up.