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01.11.2003 | Cardiac

Multidetector-row computed tomography of the coronary arteries: predictive value and quantitative assessment of non-calcified vessel-wall changes

verfasst von: Konstantin Nikolaou, Sonja Sagmeister, Andreas Knez, Ernst Klotz, Bernd J. Wintersperger, Christoph R. Becker, Maximilian F. Reiser

Erschienen in: European Radiology | Ausgabe 11/2003

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Abstract

The aim of this study was to quantitatively assess non-calcified coronary artery plaques and to determine their predictive value for the detection of coronary artery disease (CAD). A total of 179 patients underwent a calcium screening examination and a contrast-enhanced multidetector-row computed tomography angiography (MDCT) of the coronary arteries for various indications. The traditional calcium scores were evaluated and all examinations were reviewed for the presence of non-calcified plaques with an attenuation of 0–130 Hounsfield units (HU). The number, mean attenuation, and volume of these non-calcified plaques were recorded. All patients also underwent conventional catheter angiography. Coronary calcium was detected in 73% (131 of 179) of the patients. Overall incidence of purely non-calcified plaques was 30% (53 of 179). In 27% of the patients (48 of 179) no calcium was detected; however, 15% of these patients without calcifications showed non-calcified plaques (7 of 48). Significant correlations were found between the volume of calcified plaques, volume of non-calcified plaques, and total plaque volume. There were significant differences in plaque composition comparing different risk factor profiles and different stages of CAD. Volumetric assessment of non-calcified coronary artery plaques is feasible using contrast-enhanced MDCT. Screening for non-calcified plaques identifies patients with signs of CAD that are missed in a calcium screening examination.

Fuster V, Fayad ZA, Badimon JJ (1999) Acute coronary syndromes: biology. Lancet 353 (Suppl 2):5–9CrossRef

Pasterkamp G, Falk E, Woutman H, Borst C (2000) Techniques characterizing the coronary atherosclerotic plaque: influence on clinical decision making? J Am Coll Cardiol 36:13–21CrossRef

Fayad ZA, Fuster V, Nikolaou K, Becker C (2002) Computed tomography and magnetic resonance imaging for noninvasive coronary angiography and plaque imaging: current and potential future concepts. Circulation 106:2026–2034CrossRef

Becker CR, Knez A, Jakobs TF, Aydemir S, Becker A, Schoepf UJ et al. (1999) Detection and quantification of coronary artery calcification with electron-beam and conventional CT. Eur Radiol 9:620–624CrossRef

Virmani R, Kolodgie FD, Burke AP, Farb A, Schwartz SM (2000) Lessons from sudden coronary death: a comprehensive morphological classification scheme for atherosclerotic lesions. Arterioscler Thromb Vasc Biol 20:1262–1275CrossRef

Virmani R, Burke AP, Farb A (2001) Sudden cardiac death. Cardiovasc Pathol 10:211–218CrossRef

Burke AP, Taylor A, Farb A, Malcom GT, Virmani R (2000) Coronary calcification: insights from sudden coronary death victims. Z Kardiol 89 (Suppl 2):49–53CrossRef

Oliver TB, Lammie GA, Wright AR, Wardlaw J, Patel SG, Peek R et al. (1999) Atherosclerotic plaque at the carotid bifurcation: CT angiographic appearance with histopathologic correlation. Am J Neuroradiol 20:897–901PubMed

Becker CR, Knez A, Leber A, Treede H, Haberl R, Reiser MF (2001) Angiography with multi-slice spiral CT: detecting plaque before it causes symptoms. MMW Fortschr Med 143:30–32PubMed

10.

Becker CR, Knez A, Ohnesorge B, Schoepf UJ, Reiser MF (2000) Imaging of noncalcified coronary plaques using helical CT with retrospective ECG gating. Am J Roentgenol 175:423–424CrossRef

11.

Stary HC (2000) Natural history and histological classification of atherosclerotic lesions: an update. Arterioscler Thromb Vasc Biol 20:1177–1178CrossRef

12.

Becker CR, Nikolaou K, Muders M, Babaryka G, Crispin A, Schoepf UJ et al. (2003) Ex-vivo coronary atherosclerotic plaque characterization with multi-detector-row CT. Eur Radiol DOI 10.1007/s00330-003-1889-5

13.

Becker CR, Knez A, Leber A, Hong C, Treede H, Wildhirt S et al. (2000) Initial experiences with multi-slice detector spiral CT in diagnosis of arteriosclerosis of coronary vessels. Radiologe 40:118–122CrossRef

14.

Agatston AS, Janowitz WR, Hildner FJ, Zusmer NR, Viamonte M, Detrano F (1990) Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol 15:827–832CrossRef

15.

Callister TQ, Cooil B, Raya SP, Lippolis NJ, Russo DJ, Raggi P (1998) Coronary artery disease: improved reproducibility of calcium scoring with an electron-beam CT volumetric method. Radiology 208:807–814CrossRef

16.

Hong C, Becker CR, Schoepf UJ, Ohnesorge B, Bruening R, Reiser MF (2002) Coronary artery calcium: absolute quantification in nonenhanced and contrast-enhanced multi-detector row CT studies. Radiology 223:474–480CrossRef

17.

Georgiou D, Budoff MJ, Kaufer E, Kennedy JM, Lu B, Brundage BH (2001) Screening patients with chest pain in the emergency department using electron beam tomography: a follow-up study. J Am Coll Cardiol 38:105–110CrossRef

18.

Lamont DH, Budoff MJ, Shavelle DM, Shavelle R, Brundage BH, Hagar JM (2002) Coronary calcium scanning adds incremental value to patients with positive stress tests. Am Heart J 143:861–867CrossRef

19.

Kopp AF, Schroeder S, Baumbach A, Kuettner A, Georg C, Ohnesorge B et al. (2001) Non-invasive characterisation of coronary lesion morphology and composition by multislice CT: first results in comparison with intracoronary ultrasound. Eur Radiol 11:1607–1611CrossRef

20.

Taguchi R, Takasu J, Itani Y, Yamamoto R, Yokoyama K, Watanabe S et al. (2001) Pericardial fat accumulation in men as a risk factor for coronary artery disease. Atherosclerosis 157:203–209CrossRef

21.

Stary HC, Chandler AB, Glagov S, Guyton JR, Insull W Jr, Rosenfeld ME et al. (1994) A definition of initial, fatty streak, and intermediate lesions of atherosclerosis: a report from the Committee on Vascular Lesions of the Council on Arteriosclerosis, American Heart Association. Circulation 89:2462–2478CrossRef

22.

Glagov S, Weisenberg E, Zarins CK, Stankunavicius R, Kolettis GJ (1987) Compensatory enlargement of human atherosclerotic coronary arteries. N Engl J Med 316:1371–1375CrossRef

23.

Losordo DW, Rosenfield K, Kaufman J, Pieczek A, Isner JM (1994) Focal compensatory enlargement of human arteries in response to progressive atherosclerosis: in-vivo documentation using intravascular ultrasound. Circulation 89:2570–2577CrossRef

24.

Little WC, Constantinescu M, Applegate RJ, Kutcher MA, Burrows MT, Kahl FR et al. (1988) Can coronary angiography predict the site of a subsequent myocardial infarction in patients with mild-to-moderate coronary artery disease? Circulation 78:1157–1166CrossRef

25.

Giroud D, Li JM, Urban P, Meier B, Rutishauer W (1992) Relation of the site of acute myocardial infarction to the most severe coronary arterial stenosis at prior angiography. Am J Cardiol 69:729–732CrossRef

26.

Stary HC, Chandler AB, Dinsmore RE, Fuster V, Glagov S, Insull W Jr et al. (1995) A definition of advanced types of atherosclerotic lesions and a histological classification of atherosclerosis: a report from the Committee on Vascular Lesions of the Council on Arteriosclerosis, American Heart Association. Arterioscler Thromb Vasc Biol 15:1512–1531CrossRef

27.

Jakobs TF, Becker CR, Ohnesorge B, Flohr T, Suess C, Schoepf UJ et al. (2002) Multislice helical CT of the heart with retrospective ECG gating: reduction of radiation exposure by ECG-controlled tube current modulation. Eur Radiol 12:1081–1086CrossRef

Titel: Multidetector-row computed tomography of the coronary arteries: predictive value and quantitative assessment of non-calcified vessel-wall changes
verfasst von: Konstantin Nikolaou
Sonja Sagmeister
Andreas Knez
Ernst Klotz
Bernd J. Wintersperger
Christoph R. Becker
Maximilian F. Reiser
Publikationsdatum: 01.11.2003
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 11/2003
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-003-2053-y

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Multidetector-row computed tomography of the coronary arteries: predictive value and quantitative assessment of non-calcified vessel-wall changes

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