Comparison of measurement of cross-sectional coronary atherosclerotic plaque and vessel areas by 16-slice multidetector computed tomography versus intravascular ultrasound (original) (raw)
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The American Journal of Cardiology, 2008
Multidetector computed tomography (MDCT) permits the visualization of the coronary arteries and of coronary atherosclerotic plaques. The natural course of noncalcified plaque is not known. This study was conducted to measure the change in noncalcified coronary plaque volume in the left main coronary artery and in the proximal left anterior descending coronary artery over time using 64-slice MDCT. Fifty patients in whom noncalcified lesions had been detected on baseline MDCT received follow-up scans after an interval of 17 ؎ 6 months. Plaque areas were traced manually in serial multiplanar reconstructions to determine overall volume. The mean plaque volumes were 92 ؎ 81 mm 3 on baseline MDCT and 115 ؎ 110 mm 3 on follow-up MDCT (p <0.001). The mean annualized volume change was 22% (95% confidence interval 14.7% to 29.7%). A weak but significant correlation with low-density lipoprotein cholesterol level was observed for the amount of baseline plaque volume (r ؍ 0.37, p <0.001). In conclusion, the quantification of noncalcified plaque volume is possible on repeated 64-slice MDCT. A significant increase of the amount of noncalcified plaque was observed over a mean interval of 17 months. Contrast-enhanced MDCT may therefore be a tool to study the progression of coronary atherosclerosis.
Korean circulation journal, 2009
Non-invasive detection and characterization of plaque composition may constitute an important step in risk stratification and monitoring of the progression of coronary atherosclerosis. Multislice computed tomography (MSCT) allows for accurate, non-invasive detection and characterization of atherosclerotic plaques, as well as determination of coronary artery stenosis. The aim of this study was to determine the usefulness of MSCT for characterizing non-calcified coronary plaques previously classified by intravascular ultrasound (IVUS). Seventy-one plaques were evaluated in 42 patients undergoing MSCT and IVUS. Coronary plaques were classified as hypoechoic or hyperechoic based on IVUS echogenicity. On MSCT, CT attenuation was measured using circular regions of interest (ROI) and represented as Hounsfield units (HU). MSCT attenuation in hypoechoic plaques was significantly lower than it was in hyperechoic plaques (52.9+/-24.6 HU vs. 98.6+/-34.9 HU, respectively, p<0.001). When compa...
Investigative Radiology, 2010
To determine the reproducibility, accuracy, and predictors of accuracy of computed tomography (CT) angiography to detect and characterize coronary atherosclerotic plaque as compared with intravascular ultrasound. Methods: Ten ex vivo human coronary arteries were imaged in a moving phantom by dual-source CT (collimation: 0.6 mm, reconstructed slice thickness: 0.4 mm) and intravascular ultrasound (IVUS). Coregistered crosssections were assessed at 0.4 mm intervals for the presence and composition of atherosclerotic plaque (noncalcified, mixed, and calcified) on CT and IVUS by independent readers to determine reader agreement and diagnostic accuracy. Quantitative measurements of lumen and plaque area, plaque eccentricity, and intimal thickness on IVUS were used to determine predictors for the detection of noncalcified plaque by CT. Results: Within 1002 coregistered cross-sections, the interobserver agreement to detect plaque on CT was K ϭ 0.48, K ϭ 0.42, and K ϭ 1.00 for noncalcified, mixed, and calcified plaque; respectively. The sensitivity and specificity of CT was 57% out of 84% for noncalcified, 32% of 92% for mixed, and 56% of 93% for calcified plaque when compared with IVUS; respectively. Misclassification occurred in 68% of mixed and 43% of noncalcified plaques. The odds of detecting noncalcified plaque in CT independently increased by 56% (95% CI: 47%-77%, P Ͻ 0.0001) with every 0.1 mm increase in maximum intimal thickness as measured by IVUS. Detection rate for noncalcified plaques was poor for plaques Ͻ1 mm (36%) but excellent for plaques Ͼ1 mm maximal intimal thickness (90%). Conclusion: Reader agreement and diagnostic accuracy for the detection of coronary atherosclerotic plaque vary with plaque composition. Intimal thickness independently predicts detection of noncalcified plaque by CT with excellent sensitivity for Ͼ1 mm thick plaques.
Clinical Medicine Insights: Cardiology, 2015
We studied the progression of coronary atherosclerosis over time as detected by multidetector computed tomography (MDCT) in relation to risk factors and plaque composition. BACkgROund: Studies using MDCT are limited to the assessment of the degree of stenosis without taking into consideration the plaque composition that is seen by MDCT. MeThOdS: This study included 200 patients, complaining of chest pain and referred to do 64/128contrast-enhanced MDCT for the second time, and both studies were retrieved and evaluated for the presence of plaque, plaque type, vessel wall remodeling, percent area, and diameter stenosis and compared in both studies. Plaque progression over time and its association with risk factors were determined. ReSulTS: We included 200 patients, and 348 plaques were detected by 64/128 MDCT. The duration between followup and baseline studies was 25.9 ± 19.2 month. In all, 200 plaques showed progression (57.47%), 122 were stable (35.06%), and 26 regressed (7.47%). In longitudinal regression analysis, the presence of history of diabetes mellitus and dyslipidemia and the absence of intraplaque calcium deposits were independently associated with plaque pro gression over time (P , 0.0001). COnCluSIOn: Coronary plaque burden of patients with chest pain and no history of acute coronary syndrome significantly increased over time. Progression is dependent on plaque composition and cardiovascular risk factors. Larger studies and longer followup period are needed to confirm the determinant factors for plaque progression.
Zhonghua xin xue guan bing za zhi, 2007
To explore the diagnostic feasibility of noninvasive assessment of coronary atherosclerotic plaques with MSCT in comparison with IVUS. Contrast-enhanced MSCT angiography (Sensation 64, Siemens Medical Solutions) was performed before percutaneous coronary intervention (PCI), and three-vessel IVUS (Boston Scientific, Natick, MA) was performed during procedure in 12 patients with stable angina pectoris. Complete investigation was digitally stored, and assessed offline with EchoPlaque (Indec Systems, Mountain View, CA). The comparison of MSCT with IVUS was performed based on segment at plaque site (American Heart Association 15-segment model). A total of 88 segments in 31 vessels (left anterior descending: 12, left circumflex: 10, and right coronary artery: 9) were investigated by both IVUS and MSCT. Among 68 assessable segments (54 proximal-middle segments and 14 distal segments) by MSCT (20 segments were excluded for poor image quality: 16 for severe calcification, 2 for motion artifa...
Journal of Cardiology & Cardiovascular Therapy
Different authors had previously compared MDCT with IVUS, indicating a good agreement between these two methods [7,8]. Data showed that both techniques appeared to be highly accurate for estimating luminal area, plaque volume, plaque burden as well as detecting plaque morphology [9]. It was crucial to evaluate the accordance between MDCT and IVUS in a detailed manner Abstract Objectives: To correlate multi-detector computed tomography (MDCT) with intra vascular ultrasound (IVUS) for assessment of coronary circulation. Patients and methods: This prospective comparative study was held in the cardiovascular department of Benha University Hospital and Military Production Hospital in the period between May 2016 and May 2018. Fifty patients with ischemic heart disease were included in this study and planned for coronary angiography. MDCT and IVUS were performed within 72 hours before coronary angiography. Coronary dimensions were obtained by both techniques. All measurements were collected and compared at the level of patient, vessel and segment. Results: Impaired level profile was the most prevalent risk factor (62%). At all levels, using both IVUS and MDCT, minimal luminal area, minimal luminal diameter and plaque burden were highly correlated, and this correlation was statistically significant (P<0.001). Conclusion: MDCT shows significant correlation with IVUS for the assessment of coronary lumens' dimensions regardless to plaque burden even (>40%) or (<40%).
Arteriosclerosis, Thrombosis, and Vascular Biology, 2008
Objective-To assess the association between cardiovascular risk factors and extent of noncalcified-(NCAP), mixed-(MCAP), and calcified coronary atherosclerotic plaque (CAP). Methods and Results-In this cross-sectional study, we included consecutive subjects who presented with chest pain but had no history of coronary artery disease (CAD) and did not develop acute coronary syndrome. Contrast-enhanced 64-slice coronary MDCT was performed to determine the presence of NCAP, MCAP, and CAP for each coronary segment. Among 195 patients (91 women, mean age: 54.6Ϯ12.0) exclusively NCAP was detected in 11 patients (5.6%). The extent of NCAP decreased and the extent of MCAP and CAP increased with age (Pϭ0.06, Pϭ0.02, and Pϭ0.13, respectively). Hyperlipidemia and family history of CAD were associated with the extent of NCAP after adjusting for other risk factors (Pϭ0.02 and Pϭ0.04, respectively) or for the extent of MCAP and CAP (Pϭ0.02 and Pϭ0.05, respectively). Conclusions-Our data suggest that only a small proportion of individuals have exclusively NCAP and indicate that the relation of NCAP and CAP changes with age. Among individual risk factors, hyperlipidemia and family history of CAD may be associated with the extent of NCAP. Larger observational trials are necessary to confirm our findings.