Detection of coronary plaque by computed tomography with a novel plaque analysis system, 'Plaque Map', and comparison with intravascular ultrasound and angioscopy.
BACKGROUND
Previous reports suggest that plaque may be characterized by the computed tomography (CT) number, but there is not a comprehensive method for evaluating the gray-scale CT image of the coronary artery obtained by multi-detector row CT (MDCT).


RESULTS
Forty-five patients with acute coronary syndrome (ACS) underwent MDCT either 3-4 weeks after the onset of acute myocardial infarction (n=24) or within 1 week after percutaneous coronary intervention in patients with unstable angina (UA; n=21). The cross-sections obtained at intervals of 5 mm were converted to numerical data and a 'plaque map' was drawn using the color-based isometric line method and bird's eye view. 'Plaque map' was compared with the findings of intravascular ultrasound (IVUS) and angioscopy. Of 662 slices of 78 vessels, soft, intermediate or calcified plaque was detected in 144, 134, and 84 slices, respectively. Compared with IVUS, the sensitivities were 92%, 87%, and 89%, respectively, and compared with angioscopy, sensitivity was 80% and specificity was 87%.


CONCLUSIONS
MDCT with the 'Plaque Map' system can noninvasively characterize plaque in patients with ACS.
Komatsu
Sei
S
Cardiovascular Division, Osaka Police Hospital, Osaka, Japan. donai@muc.biglobe.ne.jp
Hirayama
Atsushi
A
Omori
Yosuke
Y
Ueda
Yasunori
Y
Mizote
Isamu
I
Fujisawa
Yasuo
Y
Kiyomoto
Masayoshi
M
Higashide
Toshiaki
T
Kodama
Kazuhisa
K
D002114:Calcinosis / Q000000981:diagnostic imaging; D003327:Coronary Disease / Q000000981:diagnostic imaging; D023921:Coronary Stenosis / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods