Accuracy of multidetector spiral computed tomography in identifying and differentiating the composition of coronary atherosclerotic plaques. A comparative study with intracoronary ultrasound

作者: Alexander W Leber , Andreas Knez , Alexander Becker , Christoph Becker , Franz von Ziegler

DOI: 10.1016/J.JACC.2003.10.059

关键词: Coronary atherosclerosisVascular diseaseUltrasoundCirculatory systemPlaque compositionHounsfield scaleRadiologySpiral computed tomographyIntracoronary ultrasoundMedicine

摘要: Abstract Objectives We evaluated the accuracy of contrast-enhanced multidetector spiral computed tomography (MDCT) for noninvasive detection and classification coronary plaques compared it with intracoronary ultrasound (ICUS). Background Noninvasive determination plaque composition burden may be important to improve risk stratification monitor progression atherosclerosis. Methods included 46 consecutive patients a distinctive profile, who were investigated by ICUS (Goldvision, 20 MHz, Jomed Inc., Rancho Cordova, California). Due inability slow heart rate below 65 beats/min (n = 7) due renal insufficiency 2), nine could not studied MDCT (Sensation 16, Siemens, Forchheim, Germany). Results In remaining 37 patients, 68 vessels ICUS, 58 these visualized image quality sufficient analysis. that divided in 3-mm sections, correctly classified 62 80 (78%) sections containing hypoechoic areas, 87 112 hyperechoic 150 158 (95%) calcified tissue. 484 525 (92%) atherosclerotic lesions excluded. The MDCT-derived density measurements within revealed significantly different values (49 HU [Hounsfield Units] ± 22), (91 (391 156, p Conclusions This study demonstrates that, case diagnostic quality, permits an accurate identification measured reflect echogenity composition.

参考文章(28)
Andreas Knez, Christoph Becker, Alexander Becker, Alexander Leber, Carl White, Maximilian Reiser, Gerhard Steinbeck, Determination of coronary calcium with multi-slice spiral computed tomography: a comparative study with electron-beam CT. International Journal of Cardiovascular Imaging. ,vol. 18, pp. 295- 303 ,(2002) , 10.1023/A:1015536705455
Stephen Schroeder, Andreas F Kopp, Andreas Baumbach, Christoph Meisner, Axel Kuettner, Christian Georg, Bernd Ohnesorge, Christian Herdeg, Claus D Claussen, Karl R Karsch, Noninvasive detection and evaluation of atherosclerotic coronary plaques with multislice computed tomography11This study was performed without additional financial support. Journal of the American College of Cardiology. ,vol. 37, pp. 1430- 1435 ,(2001) , 10.1016/S0735-1097(01)01115-9
Lewis Wexler, Bruce Brundage, John Crouse, Robert Detrano, Valentin Fuster, Jamshid Maddahi, John Rumberger, William Stanford, Richard White, Kathryn Taubert, Coronary artery calcification: pathophysiology, epidemiology, imaging methods, and clinical implications. A statement for health professionals from the American Heart Association. Writing Group. Circulation. ,vol. 94, pp. 1175- 1192 ,(1996) , 10.1161/01.CIR.94.5.1175
Dieter Ropers, Ulrich Baum, Karsten Pohle, Katharina Anders, Stefan Ulzheimer, Bernd Ohnesorge, Christian Schlundt, Werner Bautz, Werner G. Daniel, Stephan Achenbach, Detection of Coronary Artery Stenoses With Thin-Slice Multi-Detector Row Spiral Computed Tomography and Multiplanar Reconstruction Circulation. ,vol. 107, pp. 664- 666 ,(2003) , 10.1161/01.CIR.0000055738.31551.A9
Patrick G O’Malley, Allen J Taylor, Jeffrey L Jackson, Terence M Doherty, Robert C Detrano, Prognostic value of coronary electron-beam computed tomography for coronary heart disease events in asymptomatic populations. American Journal of Cardiology. ,vol. 85, pp. 945- 948 ,(2000) , 10.1016/S0002-9149(99)00906-6
Masanori Asakura, Yasunori Ueda, Osamu Yamaguchi, Takayoshi Adachi, Atsushi Hirayama, Masatsugu Hori, Kazuhisa Kodama, Extensive development of vulnerable plaques as a pan-coronary process in patients with myocardial infarction: an angioscopic study Journal of the American College of Cardiology. ,vol. 37, pp. 1284- 1288 ,(2001) , 10.1016/S0735-1097(01)01135-4
Alexander W. Leber, Andreas Knez, Carl W. White, Alexander Becker, Franz von Ziegler, Olaf Muehling, Christoph Becker, Maximilian Reiser, Gerhard Steinbeck, Peter Boekstegers, Composition of coronary atherosclerotic plaques in patients with acute myocardial infarction and stable angina pectoris determined by contrast-enhanced multislice computed tomography American Journal of Cardiology. ,vol. 91, pp. 714- 718 ,(2003) , 10.1016/S0002-9149(02)03411-2
Robert C. Detrano, Terence M. Doherty, Michael J. Davies, Herbert C. Stary, Predicting coronary events with coronary calcium: pathophysiologic and clinical problems. Current Problems in Cardiology. ,vol. 25, pp. 369- 402 ,(2000) , 10.1067/MCD.2000.104848
Roberto Wayhs, Allan Zelinger, Paolo Raggi, High coronary artery calcium scores pose an extremely elevated risk for hard events Journal of the American College of Cardiology. ,vol. 39, pp. 225- 230 ,(2002) , 10.1016/S0735-1097(01)01737-5
Axel Schmermund, Dietrich Baumgart, Michael Adamzik, Junbo Ge, Dietrich Grönemeyer, Rainer Seibel, Cornelia Sehnert, Günter Görge, Michael Haude, Raimund Erbel, Comparison of electron-beam computed tomography and intracoronary ultrasound in detecting calcified and noncalcified plaques in patients with acute coronary syndromes and no or minimal to moderate angiographic coronary artery disease. American Journal of Cardiology. ,vol. 81, pp. 141- 146 ,(1998) , 10.1016/S0002-9149(97)00890-4