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Atherosclerotic plaque characterization by multidetector row computed tomography angiography.
Marco A S Cordeiro1, João A C Lima
1Division of Cardiology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Journal of the American College of Cardiology
|April 25, 2006
Summary
Multidetector row computed tomography angiography (MDCTA) offers a promising alternative for assessing vessel anatomy and atherosclerotic plaque. Newer MDCTA technology shows improved accuracy in measuring plaque characteristics like area, volume, and remodeling.
Area of Science:
- Cardiovascular Imaging
- Radiology
- Medical Diagnostics
Background:
- Multidetector row computed tomography angiography (MDCTA) is emerging as a viable imaging modality.
- It is being explored as an alternative to existing methods for evaluating vessel anatomy and atherosclerotic plaque.
- Advances in technology have significantly enhanced its diagnostic capabilities.
Purpose of the Study:
- To evaluate the diagnostic accuracy of MDCTA in assessing atherosclerotic plaque.
- To compare MDCTA's performance with intravascular ultrasound (IVUS) and histopathology.
- To assess MDCTA's ability to measure plaque area, volume, and remodeling.
Main Methods:
- Utilized multidetector row computed tomography angiography (MDCTA) with advancements in gantry speed and detector rows (up to 64).
- Compared MDCTA findings with intravascular ultrasound (IVUS) and histopathology.
- Analyzed plaque composition (soft, intermediate, calcified), area, volume, and remodeling.
Main Results:
- MDCTA demonstrates good correlation with IVUS and histopathology for plaque characterization.
- 12-detector row MDCTA tends to underestimate plaque area/volume and overestimate remodeling in small vessels.
- 16- and 64-detector row MDCTA show improved accuracy in measuring plaque area, volume, and remodeling, correlating well with IVUS.
Conclusions:
- MDCTA shows significant potential for characterizing atherosclerotic plaque composition and morphology.
- Advancements in MDCTA technology, particularly 64-detector row systems, offer greater accuracy in quantitative plaque assessment.
- MDCTA is a promising tool for future cardiovascular imaging and plaque analysis.