Multidetector-row computed tomography of the coronary arteries: predictive value and quantitative assessment of non-calcified vessel-wall changes.
The aim of this study was to quantitatively assess non-calcified coronary artery plaques and to determine their predictive value for the detection of coronary artery disease (CAD). A total of 179 patients underwent a calcium screening examination and a contrast-enhanced multidetector-row computed tomography angiography (MDCT) of the coronary arteries for various indications. The traditional calcium scores were evaluated and all examinations were reviewed for the presence of non-calcified plaques with an attenuation of 0-130 Hounsfield units (HU). The number, mean attenuation, and volume of these non-calcified plaques were recorded. All patients also underwent conventional catheter angiography. Coronary calcium was detected in 73% (131 of 179) of the patients. Overall incidence of purely non-calcified plaques was 30% (53 of 179). In 27% of the patients (48 of 179) no calcium was detected; however, 15% of these patients without calcifications showed non-calcified plaques (7 of 48). Significant correlations were found between the volume of calcified plaques, volume of non-calcified plaques, and total plaque volume. There were significant differences in plaque composition comparing different risk factor profiles and different stages of CAD. Volumetric assessment of non-calcified coronary artery plaques is feasible using contrast-enhanced MDCT. Screening for non-calcified plaques identifies patients with signs of CAD that are missed in a calcium screening examination.
Nikolaou
Konstantin
K
Department of Clinical Radiology, University of Munich Grosshadern, Marchioninistrasse 15, 81377, Munich, Germany, Konstantin.Nikolaou@ikra.med.uni-muenchen.de
Sagmeister
Sonja
S
Knez
Andreas
A
Klotz
Ernst
E
Wintersperger
Bernd J
BJ
Becker
Christoph R
CR
Reiser
Maximilian F
MF
D002114:Calcinosis / Q000000981:diagnostic imaging / Q000473:pathology; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012307:Risk Factors; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed / Q000379:methods*