Ex vivo coronary atherosclerotic plaque characterization with multi-detector-row CT.
Multi-detector-row CT angiography (CTA) is a new technology that allows for non-invasive investigation of coronary atherosclerosis in patients. The relation between the morphology of atherosclerotic plaques assessed by CTA and histopathology is unknown. We investigated 11 human cadaver heart specimens. A mixture of methylcellulose and CT contrast media was injected into the coronary arteries to achieve in-vivo-like contrast enhancement within the coronary artery lumen. The morphologic pattern of atherosclerotic lesions found on CTA images and the tissue attenuation of non-calcified plaques were determined. After CTA imaging, atherosclerotic lesions in the coronary arteries were macroscopically identified and characterized histopathologically according to American Heart Association criteria. A total of 50 and 40 lesions were found macroscopically and by CTA, respectively. Thirty-three lesions could have been compared directly. The sensitivity of CTA compared with macroscopic detection of atheromas, fibroatheromas, fibrocalcified, and calcified lesions was 73, 70, 86, and 100%, respectively. The mean CT attenuation of predominantly lipid-rich and fibrous-rich plaques was significantly different (47+/-9 and 104+/-28 HU, respectively; p<0.01). Atherosclerotic coronary plaques detected by CTA may represent different stages of coronary atherosclerosis. The tissue attenuation of non-calcified plaques may allow for assessment of their predominant component.
Becker
Christoph R
CR
Department of Clinical Radiology, University of Munich, Grosshadern, Marchioninistrasse 15, 81377 Munich, Germany. christoph.becker@ikra.med.uni-muenchen.de
Nikolaou
Konstantin
K
Muders
Michael
M
Babaryka
Gregor
G
Crispin
Alexander
A
Schoepf
U Joseph
UJ
Loehrs
Udo
U
Reiser
Maximilian F
MF
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000473:pathology; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed / Q000379:methods*