Assessment of non-calcified coronary plaques using 64-slice computed tomography: comparison with intravascular ultrasound.
OBJECTIVE
Non-invasive detection and characterization of plaque composition may constitute an important step in risk stratification and monitoring of the progression of coronary atherosclerosis. Multislice computed tomography (MSCT) allows for accurate, non-invasive detection and characterization of atherosclerotic plaques, as well as determination of coronary artery stenosis. The aim of this study was to determine the usefulness of MSCT for characterizing non-calcified coronary plaques previously classified by intravascular ultrasound (IVUS).


METHODS
Seventy-one plaques were evaluated in 42 patients undergoing MSCT and IVUS. Coronary plaques were classified as hypoechoic or hyperechoic based on IVUS echogenicity. On MSCT, CT attenuation was measured using circular regions of interest (ROI) and represented as Hounsfield units (HU).


RESULTS
MSCT attenuation in hypoechoic plaques was significantly lower than it was in hyperechoic plaques (52.9+/-24.6 HU vs. 98.6+/-34.9 HU, respectively, p<0.001). When comparing CT attenuation between hypoechoic and hyperechoic plaques, 60.2 HU was the cut-off value for differentiating between the two, with a 90.7% sensitivity and a 78.6% specificity.


CONCLUSIONS
MSCT might be a useful tool for non-invasively evaluating the characteristics of coronary artery plaques.
Kim
So Yeon
SY
Department of Cardiology, College of Medicine, Catholic University of Daegu, Daegu, Korea.
Kim
Kee Sik
KS
Lee
Young Soo
YS
Lee
Jin Bae
JB
Ryu
Jae Kean
JK
Choi
Ji Yong
JY
Chang
Sung Gug
SG