title: Assessment of left main coronary artery atherosclerotic burden using 64-slice CT coronary angiography: correlation between dimensions and presence of plaques.
abstract: OBJECTIVE
  The aim of this study was to correlate left main (LM) coronary artery dimensions with the presence of atherosclerosis by multidetector-row computed tomography (MDCT) coronary angiography (CA) and to assess coronary atherosclerotic plaques with a semiquantitative method.
  
  
  METHODS
  Sixty-two consecutive patients (41 men, mean age 60+/-11) with suspected coronary artery disease underwent 64-MDCT coronary angiography. LM dimensions (length, ostial and bifurcation diameters), quantitative [location, Hounsfield unit (HU) attenuation] and qualitative (composition, shape) analysis of plaques within the LM were performed. All patients underwent conventional CA.
  
  
  RESULTS
  Thirty patients (mean age 55+/-10) without plaques in the LM presented the following average dimensions: length 10.6+/-6.1 mm, ostial diameter 5.5+/-0.7 mm, bifurcation diameter 4.9+/-0.9 mm. LM plaques (n=36) were detected in 32 patients (mean age 64+/-10) with the following LM average dimensions: length 11.3+/-4.0 mm, ostial diameter 6.0+/-1.2 mm and bifurcation diameter 6.0+/-1.2 mm. Plaques were calcified (40%, mean attenuation 742+/-191 HU), mixed (43%, mean attenuation 387+/-94 HU) or noncalcified (17%, mean attenuation 56+/-14 HU) and were frequently eccentric (77%). Age was significantly different in the two groups (p<0.05). LM diameters of patients with plaques were improved (p<0.05). A moderate correlation was found between the LM bifurcation diameter and the corresponding plaque area (r=0.56). Significant conventional CA lesions of the LM were present in just three patients (5%).
  
  
  CONCLUSIONS
  Increased LM diameters are associated with the presence of atherosclerosis. MDCT CA indicates relevant features of LM atherosclerotic burden, as rupture and subsequent thrombosis of vulnerable plaques may develop from lesions characterised as nonsignificant at conventional CA.
authors.affiliation: Dipartimento di Radiologia e Dipartimento Cardio-Polmonare, Imaging Cardiovascolare Non invasivo, Azienda Ospedaliera di Parma, Parma, Italy. filippocademartiri@hotmail.com
authors.forename: F
authors.initials: F
authors.lastname: Cademartiri
authors.forename: L
authors.initials: L
authors.lastname: La Grutta
authors.forename: R
authors.initials: R
authors.lastname: Malagò
authors.forename: F
authors.initials: F
authors.lastname: Alberghina
authors.forename: A
authors.initials: A
authors.lastname: Palumbo
authors.forename: M
authors.initials: M
authors.lastname: Belgrano
authors.forename: E
authors.initials: E
authors.lastname: Maffei
authors.forename: A
authors.initials: A
authors.lastname: Aldrovandi
authors.forename: F
authors.initials: F
authors.lastname: Pugliese
authors.forename: G
authors.initials: G
authors.lastname: Runza
authors.forename: A
authors.initials: A
authors.lastname: Weustink
authors.forename: W
authors.initials: W
authors.lastname: Bob Meeijboom
authors.forename: N R
authors.initials: NR
authors.lastname: Mollet
authors.forename: M
authors.initials: M
authors.lastname: Midiri
mesh_terms: D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed / Q000379:methods