Flat panel volume computed tomography of the coronary arteries.
OBJECTIVE
Multidetector-row computed tomography (MDCT) has evolved into a sensitive diagnostic tool for the noninvasive detection of coronary artery stenosis, but remains limited by spatial resolution. Flat panel volume computed tomography (fpVCT) offers a higher spatial resolution. In a postmortem investigation of autopsy specimens, the accuracies of fpVCT for measuring the severity of coronary artery stenosis and the size of atherosclerotic plaque components were determined.


METHODS
In 25 autopsy cases, hearts were isolated, the left anterior descending coronary arteries filled with contrast agent, and depicted with a prototype fpVCT unit with a slice thickness of 0.25 mm. Transections of the left anterior descending coronary arteries were reconstructed and compared with histopathologic sections using light microscopy.


RESULTS
FpVCT measurements of luminal stenosis (r = 0.81), total plaque area (r = 0.88), calcified plaque area (r = 0.92), noncalcified plaque area (r = 0.83), and lipid core size (r = 0.67; P < .02) correlated well with histopathology (P < .0001). The limits of agreement for measuring any plaque component were three times smaller than those reported for MDCT.


CONCLUSIONS
Postmortem coronary fpVCT provides an accurate and reproducible method for the quantitative assessment of both luminal stenosis and atherosclerotic plaque size. Because of its high spatial resolution, the method should be sufficiently accurate to reliably detect the lipid pools of vulnerable plaques.
Knollmann
Friedrich D
FD
Department of Radiology, University of Pittsburgh Medical Center, UPMC Presbyterian, Suite E-177, 200 Lothrop Street, Pittsburgh, PA 15213-2582, USA. knollmanfd@upmc.edu
Wieltsch
Annika
A
Peters
Simone
S
Mahlke
Anika
A
Niederberger
Susanne
S
Kertesz
Tereza
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002102:Cadaver; D017023:Coronary Angiography / Q000295:instrumentation* / Q000379:methods; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011856:Radiographic Image Enhancement / Q000295:instrumentation* / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014963:X-Ray Intensifying Screens