Bin Lu, Presenter: Nothing to Disclose

Wenhui Wu, Abstract Co-Author: Nothing to Disclose

Jin-Guo Lu MD, Abstract Co-Author: Nothing to Disclose

Shiliang Jiang MD, Abstract Co-Author: Nothing to Disclose

Yun Shen PhD, Abstract Co-Author: Employee, General Electric Company

Jingmin Liao, Abstract Co-Author: Nothing to Disclose

To evaluate the ability and accuracy in detecting atherosclerotic plaque in non-stenosis coronary arteries by multi-slice computed tomography (MSCT). The results were compared with the findings of intravascular ultrasound(IVUS)based on segments.

The IVUS and MSCT scans (LightSpeed 16,GE) were performed in 30 patients. A total of 94 coronary segments without significant coronary stenosis and stents were imaged and analyzed. MSCT images were evaluated for the presence and areas of plaques in the coronary segments. Plaque composition was analyzed according to IVUS (plaque echogenity: soft,intermediate,calcified) and MSCT criteria (plaque density expressed by Hounsfield Units). Results were compared with IVUS in a blinded fashion.

A total of 94 coronary artery segments were imaged and analyzed(left main,19;left anterior descending,49;left circumflex,6;right coronary,20).For the detection of segments with any plaque,MSCT had a sensitivity of 82%(46 of 56) and specificity of 89%(34 of 38).For calcified plaque,sensitivity was 92%(35of 38)and specificity 96%(54 of 56).Coronary segments containing noncalcified plaque were detected with a sensitivity of 73%(30 of 41) and specificity of 89%(47 of 53),but presence of exclusively noncalcified plaque was detected with 68% sensitivity (12 of 18). The density of 54 plaques were analyzes. With IVUS, the plaque were classified as calcified (n=19), intermediate(n=19) and soft (n=16).Using MSCT,calcified plaques had a density of 489±169(range 196 to 817 HU), intermediate plaques of 69±21(25 to 117 HU) and soft plaques 23±18 (-12 to 47). Nonparametric Kruskal-Wallis test revealed a significient difference of plaque density among the three groups (p<0.001).The mean plaque areas measured by IVUS and MDCT were 5.3mm2 versus 5.6 mm2(p<0.01, r=0.58).

MSCT has the potential to detect coronary atherosclerotic plaque without significant coronary stenosis.Coronary plaques configuration might be coreectely differentiated by MSCT.Measurements of plaques areas derived by MSCT is relatively well with IVUS.

MSCT as a noninvasive method might become an important tool for risk stratification.

Lu, B, Wu, W, Lu, J, Jiang, S, Shen, Y, Liao, J, Noninvasive Detection and Evaluation of Coronary Atherosclerotic Plaque with Multislice Spiral Computed Tomography: Comparison with Intravascular Ultrasound.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5012484.html