title: Non-invasive evaluation of atherosclerosis with contrast enhanced 16 slice spiral computed tomography: results of ex vivo investigations.
abstract: OBJECTIVE
  To evaluate the diagnostic accuracy of 16 slice computed tomography (CT) in determining plaque morphology and composition in an experimental setting. The results were compared with histopathological analysis as the reference standard.
  
  
  METHODS
  Nine human popliteal arteries derived from amputations because of atherosclerotic disease were investigated with multislice spiral CT (MSCT). Atherosclerotic lesions were morphologically classified (completely or partially occlusive, concentric, eccentric), and tissue densities were determined within these plaques. In addition, vessel dimensions were quantitatively measured.
  
  
  RESULTS
  The results were compared with histological analysis. The concordance index kappa for morphological classification was 0.88. Plaque density (n = 51 lesions) was significantly different (p < 0.0001) between lipid rich, fibrotic, and calcified lesions (Stary stage III: n = 2, 58 (8) Hounsfield units (HU); Stary V: n = 11, 50 (21) HU; Stary VI: n = 14, 96 (42) HU; Stary VII: n = 6, 858 (263) HU; Stary VIII: n = 18, 126 (99) HU). The concordance index kappa for the classification of plaques based on density was 0.51. Vessel dimensions had a good correlation (r = 0.98).
  
  
  CONCLUSIONS
  16 slice CT was found to be a reliable non-invasive imaging technique for assessing atherosclerotic plaque morphology and composition. Although calcified lesions can be differentiated from non-calcified lesions, the diagnostic accuracy in further subclassifying non-calcified plaques as lipid rich and fibrotic is low, even under experimental conditions.
authors.affiliation: Division of Cardiology, Eberhard-Karls-University Tuebingen, Tuebingen, Germany. stephen.schroeder@med.uni-tuebingen.de
authors.forename: S
authors.initials: S
authors.lastname: Schroeder
authors.forename: A
authors.initials: A
authors.lastname: Kuettner
authors.forename: T
authors.initials: T
authors.lastname: Wojak
authors.forename: J
authors.initials: J
authors.lastname: Janzen
authors.forename: M
authors.initials: M
authors.lastname: Heuschmid
authors.forename: T
authors.initials: T
authors.lastname: Athanasiou
authors.forename: T
authors.initials: T
authors.lastname: Beck
authors.forename: C
authors.initials: C
authors.lastname: Burgstahler
authors.forename: C
authors.initials: C
authors.lastname: Herdeg
authors.forename: C D
authors.initials: CD
authors.lastname: Claussen
authors.forename: A F
authors.initials: AF
authors.lastname: Kopp
mesh_terms: D003287:Contrast Media; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D011150:Popliteal Artery / Q000000981:diagnostic imaging*; D036542:Tomography, Spiral Computed / Q000379:methods*
chemical_list: D003287:Contrast Media