Since optical coherence tomography (OCT) was first performed in humans two decades ago, this imaging modality has been widely adopted in research on coronary atherosclerosis and adopted clinically for the optimization of percutaneous coronary intervention. In the past 10 years, substantial advances have been made in the understanding of in vivo vascular biology using OCT. Identification by OCT of culprit plaque pathology could potentially lead to a major shift in the management of patients with acute coronary syndromes. Detection by OCT of healed coronary plaque has been important in our understanding of the mechanisms involved in plaque destabilization and healing with the rapid progression of atherosclerosis. Accurate detection by OCT of sequelae from percutaneous coronary interventions that might be missed by angiography could improve clinical outcomes. In addition, OCT has become an essential diagnostic modality for myocardial infarction with non-obstructive coronary arteries. Insight into neoatherosclerosis from OCT could improve our understanding of the mechanisms of very late stent thrombosis. The appropriate use of OCT depends on accurate interpretation and understanding of the clinical significance of OCT findings. In this Review, we summarize the state of the art in cardiac OCT and facilitate the uniform use of this modality in coronary atherosclerosis. Contributions have been made by clinicians and investigators worldwide with extensive experience in OCT, with the aim that this document will serve as a standard reference for future research and clinical application.

自从二十年前光学相干断层扫描 (OCT) 首次在人类身上进行以来，这种成像方式已广泛应用于冠状动脉粥样硬化研究，并在临床上用于优化经皮冠状动脉介入治疗。在过去的 10 年中，在使用 OCT 了解体内血管生物学方面取得了实质性进展。通过 OCT 识别罪魁祸首斑块病理学可能会导致急性冠状动脉综合征患者管理的重大转变。通过 OCT 检测愈合的冠状动脉斑块对于我们理解斑块不稳定和随着动脉粥样硬化的快速进展而愈合的机制非常重要。通过 OCT 准确检测血管造影可能遗漏的经皮冠状动脉介入治疗的后遗症可以改善临床结果。此外，OCT 已成为非阻塞性冠状动脉心肌梗死的基本诊断方式。从 OCT 深入了解新动脉粥样硬化可以提高我们对极晚期支架内血栓形成机制的理解。OCT 的正确使用取决于对 OCT 结果临床意义的准确解释和理解。在这篇综述中，我们总结了心脏 OCT 的最新技术，并促进了这种模式在冠状动脉粥样硬化中的统一使用。世界各地在 OCT 方面具有丰富经验的临床医生和研究人员做出了贡献，