Non-invasive assessment of plaque morphology and remodeling in mildly stenotic coronary segments: comparison of 16-slice computed tomography and intravascular ultrasound.
BACKGROUND
Non-invasive identification and characterization of mildly stenotic atherosclerotic lesions is an increasingly important focus of coronary imaging.


METHODS
We examined the accuracy of multi (16)-slice computed tomography (MSCT) for imaging of these lesions in comparison with intravascular ultrasound (IVUS).


METHODS
Mildly stenotic segments of the left coronary artery were identified by coronary angiography and analyzed using IVUS and contrast-enhanced MSCT. Independent reviewers evaluated the accuracy of MSCT for presence, composition and distribution of atherosclerotic plaque and remodeling response in comparison to IVUS using receiver operating characteristic (ROC) data analysis.


RESULTS
Of 46 segments in 14 patients, diagnostic characterization by MSCT was possible in 37 (80.4%) segments. In these segments the accuracy of MSCT for identifying plaque presence, calcification, distribution and positive remodeling was consistently greater than 0.90 (reader 1) and 0.87 (reader 2).


CONCLUSIONS
State-of-the-art MSCT can accurately identify mildly stenotic coronary atherosclerosis and provide an assessment of morphology and remodeling response.
Schoenhagen
Paul
P
Department of Radiology, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
Tuzcu
E Murat
EM
Stillman
Arthur E
AE
Moliterno
David J
DJ
Halliburton
Sandra S
SS
Kuzmiak
Stacie A
SA
Kasper
Jane M
JM
Magyar
William A
WA
Lieber
Michael L
ML
Nissen
Steven E
SE
White
Richard D
RD
D000328:Adult; D000368:Aged; D016477:Artifacts; D002114:Calcinosis / Q000175:diagnosis / Q000503:physiopathology; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000175:diagnosis / Q000503:physiopathology*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D018084:Ultrasonography, Interventional; D020257:Ventricular Remodeling / Q000502:physiology*