[Noninvasive Methods of Detection of Vulnerable Atherosclerotic Plaques in Coronary Arteries]

In most cases direct cause of acute coronary syndrome and sudden death is an intracoronary thrombus formed on a surface of unstable atherosclerotic plaque (UAP). The following are main characteristics of UAP: active inflammation; large lipid rich nucleus occupying a40% of plaque volume; thin (< 65 mm) fibrous cap; erosions of intima over plaque; tear of plaque cap; superficially located calcium nodules; intraplaque hemorrhage. Visualization of UAP in coronary arteries is a very important direction in diagnostics. During recent years both invasive and noninvasive methods of detection of UAP have been actively developed. In this review we present main noninvasive techniques used for detection of UAP: multislice computed tomography, magnetic resonance tomography, positron emission tomography and single-photon emission computed tomography. In the review we have covered main advantages and limitations of each invasive method of UAP detection and delineated perspectives of development of this direction.