title: [Qualitative and quantitative evaluation of coronary plaques with 64-slice computed tomography in comparison with intravascular ultrasound].
abstract: OBJECTIVE
  To explore the diagnostic feasibility of noninvasive assessment of coronary atherosclerotic plaques with MSCT in comparison with IVUS.
  
  
  METHODS
  Contrast-enhanced MSCT angiography (Sensation 64, Siemens Medical Solutions) was performed before percutaneous coronary intervention (PCI), and three-vessel IVUS (Boston Scientific, Natick, MA) was performed during procedure in 12 patients with stable angina pectoris. Complete investigation was digitally stored, and assessed offline with EchoPlaque (Indec Systems, Mountain View, CA). The comparison of MSCT with IVUS was performed based on segment at plaque site (American Heart Association 15-segment model).
  
  
  RESULTS
  A total of 88 segments in 31 vessels (left anterior descending: 12, left circumflex: 10, and right coronary artery: 9) were investigated by both IVUS and MSCT. Among 68 assessable segments (54 proximal-middle segments and 14 distal segments) by MSCT (20 segments were excluded for poor image quality: 16 for severe calcification, 2 for motion artifact, 2 for poor opacification), MSCT correctly detected 47 of the 51 segments with plaques (sensitivity: 92%), and correctly evaluated 16 of 17 segments without plaques (specificity: 94%). Concerning plaque quantification, MSCT correlated well with IVUS in grading whether the vessel obstruction was less or more than 50% (simple kappa: 0.63, 95% CI: from 0.47 to 0.78). Plaque area by MSCT also correlated with that by IVUS (r = 0.53, P < 0.01), but overestimated plaque area [(9.09 +/- 3.89) mm(2) vs. (6.80 +/- 2.81) mm(2), P < 0.01]. In addition, 30 of 43 hypoechoic compositions were detected as low-density compositions by MSCT with average CT number as 67.39 HU.
  
  
  CONCLUSIONS
  In segments without severe calcification, contrast-enhanced 64-slice CT angiography could detect plaques in coronary artery with high accuracy. Plaque area quantification by MSCT correlated with that of IVUS though with limited accuracy.
authors.affiliation: Department of Cardiology, First Hospital of Ningbo, Ningbo 315010, China. yehonghua@medmail.com.cn
authors.forename: Hong-hua
authors.initials: HH
authors.lastname: Ye
authors.forename: Hideaki
authors.initials: H
authors.lastname: Kaneda
authors.forename: Shigeru
authors.initials: S
authors.lastname: Saito
authors.forename: Takaaki
authors.initials: T
authors.lastname: Shiono
authors.forename: Shinji
authors.initials: S
authors.lastname: Tanaka
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Miyashita
authors.forename: Saeko
authors.initials: S
authors.lastname: Takahashi
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Taketani
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Domae
mesh_terms: D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D006801:Humans; D014057:Tomography, X-Ray Computed / Q000379:methods; D018084:Ultrasonography, Interventional