Alessandro Napoli MD, Presenter: Nothing to Disclose

Carlo Catalano MD, Abstract Co-Author: Nothing to Disclose

Beatrice Cavallo Marincola, Abstract Co-Author: Nothing to Disclose

Chiara Zini, Abstract Co-Author: Nothing to Disclose

Francesca Antonella Calabrese MD, Abstract Co-Author: Nothing to Disclose

Roberto Passariello MD, Abstract Co-Author: Nothing to Disclose

To evaluate the correlations between location, extent and severity of arterial involvement using 64-detector row CT Angiography (64CTA) and Framingham risk index (FRI) in patients with Metabolic Syndrome.

243 consecutive patients with known metabolic syndrome underwent Whole Body 64CTA (Sensation Cardiac, Siemens). Two image data sets were acquired using a 64x0.6mm detector configuration with an adapted contrast [400mgI/mL] injection protocol. ECG-gated coronary scanning with automatic dose modulation was performed first, followed by an ultra-low dose (80 kVp) scan of the entire arterial system. Coronary artery and whole body arterial districts were divided into 15 (according to NYHA) and 32 segments, respectively. Images were assessed for vascular pathology (normal; moderate or severe stenosis; occlusion and aneurysm). FRI was correlated to location, extent, and severity of coronary and/or extra-coronary atherosclerotic lesions for each patient.

A total of 2916 coronary and 7711 extracoronary arterial segments were evaluated. On a per segment basis, atherosclerotic lesions were observed in 691(20%) coronary and 1044 (13%) extra-coronary segments. Severe (>75%) stenosis was assessed in 23 coronary and 50 extracoronary segments. Sensitivity and specificity for detection of severe stenosis was 77% and 95% in 34 patients with selective coronary angiography data. Patients categorized as mild-risk (>10; <20%) according to FRI presented similar extent (p=0.93) of arterial involvement and location (p=0.48) as those at high-risk. There was a modest, significant relationship between severe stenosis as depicted by 64CTA and high-risk indices (r=0.35, P=0.002).

64CTA is an emerging non-invasive modality for imaging atherosclerosis in both coronary and extracoronary arteries. The early detection of atherosclerotic disease in patients with mild cardiovascular risk has potential for preventive therapy.

Whole-body CT Angiography allows direct quantitative arterial involvement in patients with metabolic syndrome and has potential for preventive therapy.

Napoli, A, Catalano, C, Cavallo Marincola, B, Zini, C, Calabrese, F, Passariello, R, Metabolic Syndrome and Accelerated Atherosclerosis: From Clinical Data to Quantitative Arterial Involvement—An Emerging Application of Whole Body CT Angiography.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5011885.html