title: Ex vivo coronary atherosclerotic plaque characterization with multi-detector-row CT.
abstract: 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.
authors.affiliation: Department of Clinical Radiology, University of Munich, Grosshadern, Marchioninistrasse 15, 81377 Munich, Germany. christoph.becker@ikra.med.uni-muenchen.de
authors.forename: Christoph R
authors.initials: CR
authors.lastname: Becker
authors.forename: Konstantin
authors.initials: K
authors.lastname: Nikolaou
authors.forename: Michael
authors.initials: M
authors.lastname: Muders
authors.forename: Gregor
authors.initials: G
authors.lastname: Babaryka
authors.forename: Alexander
authors.initials: A
authors.lastname: Crispin
authors.forename: U Joseph
authors.initials: UJ
authors.lastname: Schoepf
authors.forename: Udo
authors.initials: U
authors.lastname: Loehrs
authors.forename: Maximilian F
authors.initials: MF
authors.lastname: Reiser
mesh_terms: 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*