Comprehensive evaluation of noncalcified coronary plaque characteristics detected using 64-slice computed tomography in patients with proven or suspected coronary artery disease.
BACKGROUND
Multislice computed tomography has recently been shown to have the potential to characterize noncalcified coronary atherosclerotic lesions (NCALs). We evaluated the relationship among computed tomography (CT) density, arterial remodeling, and the adherent calcium morphology of NCALs detected using 64-slice CT.


METHODS
We studied 138 patients with proven or suspected coronary artery disease who underwent contrast-enhanced 64-slice CT examination. For each NCAL detected within the vessel wall, we determined the minimum CT density, remodeling index (RI = lesion/reference vessel area), and the presence or absence of coronary calcium in or adjacent to each NCAL and its morphology. Intravascular ultrasound (IVUS) was additionally performed in a subset of 21 patients.


RESULTS
A total of 202 NCALs were detected in 97 patients. The mean CT density of 98 lesions with positive remodeling (PR) (RI >1.05) was significantly lower than that of 104 lesions without PR (25 +/- 23 vs 56 +/- 28 Hounsfield units, P < .001); and spotty calcium was more frequently observed with the PR lesions than non-PR lesions (59% vs 22%, P < .001). The mean CT density of the PR lesions with spotty calcium (n = 58) was substantially lower than that of the non-PR lesions without adherent calcium (n = 45) (20 +/- 20 vs 67 +/- 24 Hounsfield units, P < .001). Evaluation of the components, RI, and adherent calcium morphology of 38 NCALs by 64-slice CT was in close agreement with the IVUS findings.


CONCLUSIONS
Lower CT density, PR, and adherent spotty calcium, which may indicate plaque vulnerability, are intimately co-related in NCALs detected using 64-slice CT; these findings are consistent with those of IVUS.
Department of Molecular and Internal Medicine, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
Toshiro
T
Kitagawa
Hideya
H
Yamamoto
Norihiko
N
Ohhashi
Tomokazu
T
Okimoto
Jun
J
Horiguchi
Nobuhiko
N
Hirai
Katsuhide
K
Ito
Nobuoki
N
Kohno
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000473:pathology; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000473:pathology; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D036542:Tomography, Spiral Computed; D018084:Ultrasonography, Interventional