title: Comprehensive assessment of spotty calcifications on computed tomography angiography: comparison to plaque characteristics on intravascular ultrasound with radiofrequency backscatter analysis.
abstract: BACKGROUND
  The purpose of the study was to systematically compare calcification patterns in plaques on computed tomography angiography (CTA) with plaque characteristics on intravascular ultrasound with radiofrequency backscatter analysis (IVUS-VH).
  
  
  RESULTS
  In total, 108 patients underwent CTA and IVUS-VH. On CTA, calcification patterns in plaques were classified as non-calcified, spotty or dense calcifications. Plaques with spotty calcifications were differentiated into small spotty (<1 mm), intermediate spotty (1-3 mm) and large spotty calcifications (≥3 mm). Plaque characteristics deemed more high-risk on IVUS-VH were defined by % necrotic core (NC) and presence of thin cap fibroatheroma (TCFA). Overall, 300 plaques were identified both on CTA and IVUS-VH. % NC core was significantly higher in plaques with small spotty calcifications as compared to non-calcified plaques (20% vs 13%, P = .006). In addition, there was a trend for a higher % NC in plaques with small spotty calcifications than in plaques with intermediate spotty calcifications (20% vs 14%, P = .053). Plaques with small spotty calcifications had the highest % TCFA as compared to large spotty and dense calcifications (31% vs 9% and 31% vs 6%, P < .05).
  
  
  CONCLUSIONS
  Plaques with small spotty calcifications on CTA were related to plaque characteristics deemed more high-risk on IVUS-VH. Therefore, CTA may be valuable in the assessment of the vulnerable plaque.
authors.affiliation: Department of Cardiology, Leiden University Medical Center, Postal Zone: C5-P, P.O. Box 9600, 2333 ZA, Leiden, The Netherlands.
authors.forename: Joëlla E
authors.initials: JE
authors.lastname: van Velzen
authors.forename: Fleur R
authors.initials: FR
authors.lastname: de Graaf
authors.forename: Michiel A
authors.initials: MA
authors.lastname: de Graaf
authors.forename: Joanne D
authors.initials: JD
authors.lastname: Schuijf
authors.forename: Lucia J
authors.initials: LJ
authors.lastname: Kroft
authors.forename: Albert
authors.initials: A
authors.lastname: de Roos
authors.forename: Johan H C
authors.initials: JH
authors.lastname: Reiber
authors.forename: Jeroen J
authors.initials: JJ
authors.lastname: Bax
authors.forename: J Wouter
authors.initials: JW
authors.lastname: Jukema
authors.forename: Eric
authors.initials: E
authors.lastname: Boersma
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Schalij
authors.forename: Ernst E
authors.initials: EE
authors.lastname: van der Wall
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed; D018084:Ultrasonography, Interventional; D061205:Vascular Calcification / Q000000981:diagnostic imaging*