[Evaluating multislice computed tomography for imaging coronary atherosclerosis]

Area of Science:

• Cardiovascular Imaging
• Radiology
• Pathology

Background:

• Atherosclerotic coronary artery disease (CAD) is a leading cause of mortality.
• Accurate assessment of coronary artery plaque burden and composition is crucial for risk stratification.
• Multidetector-row computed tomography (MDCT) offers potential for non-invasive evaluation of coronary atherosclerosis.

Purpose of the Study:

• To evaluate the efficacy of MDCT in assessing atherosclerotic changes in coronary artery vessel walls.
• To develop and validate imaging criteria for different plaque types using MDCT.
• To assess the in vivo diagnostic performance of MDCT coronary angiography (MDCTA) for plaque detection and characterization.

Main Methods:

• Ex vivo study: 17 human hearts scanned with MDCT and compared to histopathology.
• Development of MDCT morphologic imaging criteria for lipid-rich, fibrous, and calcified plaques.
• In vivo study: Retrospective review of 94 coronary MDCT angiograms (MDCTA) for plaque assessment and volumetry.

Main Results:

• MDCT demonstrated high sensitivity for detecting calcified and non-calcified plaques ex vivo.
• Histopathology correlation enabled determination of characteristic MDCT criteria for plaque components.
• In vivo MDCTA identified noncalcified plaques in 38% of patients, even in those with a calcium score of 0.

Conclusions:

• MDCT can differentiate various coronary plaque components both ex vivo and in vivo.
• Contrast-enhanced MDCT is effective for detecting noncalcified coronary plaques.
• In vivo plaque volumetry using MDCT is technically feasible.