Abstract
Multi-detector row Computed Tomography (MDCT) permits non-invasive visualization of
the coronary arteries. The ability to visualize and, with limitations, to characterize
non-calcified coronary atherosclerotic plaque has been described. We investigated
the CT attenuation of non-calcified plaques as determined by 16-slice MDCT in comparison
to intravascular ultrasound (IVUS).
Methods and results
Thirty-two patients were investigated by contrast-enhanced 16-slice CT. In addition,
IVUS of one coronary artery (motorized pullback) was performed (LM+LAD: 22, LM+LCX:
4, RCA: 6). At 252 sites within the coronary system, in which non-calcified atherosclerotic
plaque could be identified both in MDCT and IVUS, the CT attenuation within the plaque
was measured using a centrally placed region of interest and correlated to the appearance
of the plaque in IVUS at the corresponding location. The mean CT attenuation within
plaque that corresponded to hyper-echogenic appearance in IVUS was 121 ± 34 HU (n = 76). The mean CT attenuation within plaque that corresponded to hypo-echogenic appearance
was 58 ± 43 HU (n = 176, p < 0.001). However, there was substantial overlap of the density values measured by MDCT
in the two groups.
Conclusions
A significant difference of the mean CT attenuation within atherosclerotic lesions
of hypo-echogenic and hyper-echogenic appearance in IVUS could be observed. However,
we observed substantial overlap of attenuation values between plaque types so that
the differentiation of “vulnerable” and “stable” plaques based on their CT attenuation
is doubtful.
Keywords
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Article info
Publication history
Published online: February 22, 2006
Accepted:
January 11,
2006
Received in revised form:
January 3,
2006
Received:
October 31,
2005
Identification
Copyright
© 2006 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.