[CT, MRI for diagnosis of acute coronary syndrome]

Recent pathological and clinical observations support the notion that coronary artery plaque disruption and subsequent thrombosis is the primary cause of acute coronary syndrome (ACS) including acute myocardial infarction and unstable angina. Therefore, detection and characterization of coronary artery plaques are of utmost importance in the management of patients with suspected coronary artery disease. Histologic and clinical observations using intravascular ultrasound have suggested that vulnerable, rupture-prone plaques are characterized by the presence of large lipid cores, thin fibrous caps and positive coronary artery remodeling. In this review, we describe the efficacy of multislice computed tomography (MSCT) to characterize vulnerable plaques, especially in patients with suspected ACS. In addition, the efficacy of coronary magnetic resonance imaging is discussed.