Characterization of non-calcified coronary atherosclerotic plaque by multi-detector row CT: Comparison to IVUS
Section snippets
Methods
Thirty-two patients (9 female, 23 male, mean age: 59 years) were studied (see Table 1). In all patients, MDCT had been performed as part of research protocols which enrolled consecutive subjects scheduled for invasive coronary angiography for clinical reasons. In all patients, significant coronary artery stenoses (diameter reduction >50%) were ruled out angiographically and an IVUS study of one coronary vessel was performed. Patients with arrhythmias, contraindications to iodinated contrast
Results
Two hundred and fifty-two sites within the coronary system that contained non-calcified atherosclerotic plaque could be identified in MDCT without artifacts caused by motion or extensive calcification and cross-correlated to IVUS. Table 2 lists the distribution of lesions throughout the coronary system. IVUS classified 176 cross-sections as predominantly hypo-echogenic and 76 lesions as predominantly hyper-echogenic. The mean CT density measured within lesions that had a hypo-echogenic
Discussion
We determined the CT attenuation within non-calcified coronary atherosclerotic plaques by contrast-enhanced 16-slice MDCT. By comparison to intrasvascular ultrasound, we could confirm earlier observations that plaque type has an influence on the CT density measured within the plaque: the mean CT density measured within 176 plaques that, by IVUS, were classified as “hypo-echogenic” and thus “soft” or “lipid-rich” was significantly lower than in 76 plaques that IVUS classified as
Conflict of interest disclosures
Stephan Achenbach has received research support from Siemens Medical Solutions.
Acknowledgments
Stephan Achenbach was supported in part by Deutsche Forschungsgemeinschaft. Dr. Maros Ferencik was supported in part by NIH grant 1 T32 HL076136-02.
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