title: Early characterization of atherosclerotic coronary plaques with multidetector computed tomography in patients with acute coronary syndrome: a comparative study with intravascular ultrasound.
abstract: We compared 16-slice computed tomography (CT) with intravascular ultrasound (IVUS) in their ability to identify the culprit lesion, and to assess plaque characterization and vascular remodelling in acute coronary syndrome (ACS). Twenty patients were prospectively studied. Coronary plaque identification and characterization were compared using 16-slice CT and 40-MHz catheter-based IVUS. Minimum lumen area (MLA), cross-sectional vessel area (CVA) and vessel remodelling were determined for each comparable lesion. One hundred and sixty-nine segments were compared and 84 plaques analysed. Sixteen-slice CT detected 95% of culprit lesions (19/20). No feature suggestive of plaque rupture was detected by 16-slice CT. Attenuation measurements within all lesions revealed different values for hypoechoic (38 +/- 33 HU), hyperechoic (94 +/- 44 HU), and calcified plaques (561 +/- 216 HU), (P < 0.001). Agreement between 16-slice CT and IVUS on measuring MLA and CVA was evaluated using Bland-Altman analysis. Pearson and intra-class coefficient (ICC) were 0.81 and 0.70 for MLA, and 0.81 and 0.36 for CVA, for 16-slice CT and IVUS, respectively. Agreement between both techniques for vessel positive remodelling was moderate (kappa = 0.54, P < 0.001). Sixteen-slice CT has shown moderate accuracy in quantifying and characterizing coronary plaques compared with IVUS. Spatial resolution of 16-slice CT remains a major limitation, however, to accurately assess the complex lesions involved in ACS.
authors.affiliation: Université Bordeaux 2, Inserm U 441 Atherosclerose, F 33076, 146 rue Léo Saignat, 33000, Bordeaux, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Iriart
authors.forename: Sebastien
authors.initials: S
authors.lastname: Brunot
authors.forename: Pierre
authors.initials: P
authors.lastname: Coste
authors.forename: Michel
authors.initials: M
authors.lastname: Montaudon
authors.forename: Pierre
authors.initials: P
authors.lastname: Dos-Santos
authors.forename: Lionel
authors.initials: L
authors.lastname: Leroux
authors.forename: Jean-Noel
authors.initials: JN
authors.lastname: Labeque
authors.forename: Catherine
authors.initials: C
authors.lastname: Jais
authors.forename: François
authors.initials: F
authors.lastname: Laurent
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003324:Coronary Artery Disease / Q000150:complications* / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed; D018084:Ultrasonography, Interventional