title: Risk factors associated with soft coronary artery plaques in Japanese, as determined by 16 slice multidetector-row computed tomography.
abstract: OBJECTIVE
  The acute coronary syndrome is often caused by the rupture of plaques and thrombus formation even without significant stenosis, and patients with soft plaques, but without significant stenosis evidenced by coronary angiography (CAG), often develop an acute coronary syndrome. To address this discrepancy, a qualitative diagnosis of coronary plaques using a 16 slice multidetector-row CT was conducted.
  
  
  RESULTS
  Volume rendering and cross-sectional MPR images were obtained. Based on the CT values, plaques on the coronary artery wall were classified as lipid-rich soft plaques (CT value<50 HU) and non-soft plaques (>50 HU).A significant correlation was observed between the percent stenosis determined in cross-sectional MPR images and those determined by CAG (r=+0.92, p<0.01). Diffuse plaques with CT values of less than 50 HU often caused stenosis at level of 75% or less, which were not indicated by percutaneous transluminal coronary angioplasty.
  
  
  CONCLUSIONS
  Although diffuse soft plaques with CT values less than 50 HU are not an indication of intervention, a risk of an acute coronary syndrome exists, due to rupture. These soft plaques must be stabilized by treatment even when they do not cause significant stenosis, and MDCT is considered to be useful for their evaluation.
authors.affiliation: Department of Radiology, The University of Tokushima Graduate School.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Tsujikawa
authors.forename: Masahiro
authors.initials: M
authors.lastname: Nomura
authors.forename: Kimiko
authors.initials: K
authors.lastname: Nakayasu
authors.forename: Tomohito
authors.initials: T
authors.lastname: Kawano
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Nakaya
authors.forename: Susumu
authors.initials: S
authors.lastname: Ito
authors.forename: Hiromu
authors.initials: H
authors.lastname: Nishitani
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000150:complications* / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D012307:Risk Factors; D012421:Rupture; D036542:Tomography, Spiral Computed / Q000379:methods*