Purpose
The aim of our study was to evaluate morphological features of atherosclerotic plaques in the coronary arteries and identify signs of instability by coronary CT angiography,
compare with VH-IVUS.
Methods and Materials
Twenty five patients (8 women,
age from 31 to 76 years) with acute coronary syndrome who showed significant coronary artery stenosis (> or =50% diameter stenosis) by invasive coronary angiography underwent MSCT and VH IVUS within 24 hours after onset.
Cardiac CT imaging was performed using a 64-detector row helical scanner.
CT angiography data sets were evaluated by an observer,
who was blinded to the IVUS data.
Invasive coronary angiography was performed according to the standard protocol.
During selective coronary angiography,
IVUS examinations were performed...
Results
Both techniques were well-correlated for lumen area stenosis (n=40,
r=0,78,
P<0,001),
plaque length (n=40,
r=0,69,
P<0,001),
remodeling index (n=40,
r=0,61,
P<0,001).
Twenty thin cap fibroatheromas,
fourteen fibroatheromas with rupture (complicated lesion),
six calcinated atheromas were detected by IVUS-VH.
Known signs of instability (lowdensity area,
spotty calcifications,
positive remodeling,
uneven contour,
“ringlike” enhancement) were detected in all types of plaques.
Conclusion
Compared with IVUS,
coronary CT angiography is a useful tool for detection of coronary plaque,
percentage of area stenosis,
plaque length,
remodeling index.
Known things of instability are found not only in thin-cap atheromas,
but also in fibroatheromas with rupture (complicated lesion) and calcinated atheromas among patients with acute coronary syndrome.