Non-invasive assessment of plaque rupture by 64-slice multidetector computed tomography--comparison with intravascular ultrasound.
BACKGROUND
Plaque rupture and secondary thrombus formation play key roles in the onset of acute coronary syndrome (ACS). Multidetector computed tomography (MDCT) allows the non-invasive assessment of coronary artery stenosis and plaque properties. In this study, we investigated whether 64-slice MDCT could non-invasively detect a plaque rupture in patients with de novo angina.


RESULTS
The study population comprised 67 patients with de novo angina. All patients underwent contrast-enhanced 64-slice MDCT and intravascular ultrasound (IVUS). Patients were divided into a plaque rupture group (n=27) and a non-rupture group (n=40) based on the IVUS. The 64-slice MDCT revealed that the prevalence of an ulcer-like enhancement space (37% vs 5%, p<0.01), a ring-like sign (41% vs 18%, p=0.04), in the plaque rupture group was higher than those in the non-rupture group. Maximum plaque thickness (2.1+/-0.9 mm vs 1.6+/-1.0 mm, p=0.04), outer vessel area (17.6+/-4.9 mm2 vs 13.4+/-5.0 mm2, p<0.01), percentage plaque area (82.3+/-9.1% vs 73.4+/-15.7%, p=0.01), and remodeling index (1.11+/-0.18 vs 1.01+/-0.15, p=0.04) of the plaque rupture group were all significantly larger than those of the non-rupture group.


CONCLUSIONS
The 64-slice MDCT can identify differences in lesion morphologies between ruptured plaques and non-ruptured plaques. From our results, the 64-slice MDCT might provide a useful tool for the non-invasive detection of plaque rupture.
Tanaka
Atsushi
A
Wakayama Medical University, Department of CArdiovascular Medicine, Wakayama, Japan. a-tanaka@wakayama-med.ac.jp
Shimada
Kenei
K
Yoshida
Ken
K
Jissyo
Satoshi
S
Tanaka
Hidemasa
H
Sakamoto
Makoto
M
Matsuba
Kunio
K
Imanishi
Toshio
T
Akasaka
Takashi
T
Yoshikawa
Junichi
J
D000368:Aged; D000787:Angina Pectoris / Q000000981:diagnostic imaging / Q000209:etiology*; D017023:Coronary Angiography / Q000379:methods*; D023921:Coronary Stenosis / Q000150:complications / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011857:Radiographic Image Interpretation, Computer-Assisted; D012421:Rupture; D014057:Tomography, X-Ray Computed; D018084:Ultrasonography, Interventional