Atherosclerotic plaque characterization by 0.5-mm-slice multislice computed tomographic imaging.

Area of Science:

• Cardiovascular Imaging
• Medical Diagnostics
• Radiology

Background:

• Multislice computed tomography (MSCT) at 0.5-mm slice thickness is proposed for noninvasive atherosclerotic plaque detection.
• Previous studies lacked invasive validation for MSCT plaque assessment.
• This study aimed to validate 0.5-mm slice MSCT plaque density against intravascular ultrasound (IVUS) findings.

Purpose of the Study:

• To compare the plaque density measured by 0.5-mm slice MSCT with IVUS characterization.
• To determine the accuracy of noninvasive MSCT in identifying different types of coronary atherosclerotic plaques.

Main Methods:

• Atherosclerotic plaques in 37 patients undergoing percutaneous interventions were analyzed.
• Plaques were classified as soft, fibrous, or calcified based on IVUS echogenicity.
• 0.5-mm slice MSCT plaque density (Hounsfield units) was calculated for 98 plaques and 443 regions-of-interest.

Main Results:

• MSCT plaque densities were 11+/-12 HU (soft), 78+/-21 HU (fibrous), and 516 +/-198 HU (calcified).
• Contrast-filled lumen density was 258+/-43 HU.
• Statistically significant differences were found among soft, fibrous, calcified plaques, and lumen (p<0.0001).

Conclusions:

• 0.5-mm slice MSCT accurately identifies coronary plaque configurations defined by IVUS.
• Noninvasive MSCT assessment enables focus on the vessel wall, extending beyond lumen evaluation.
• This validates MSCT as a tool for characterizing atherosclerotic plaques noninvasively.