Comparison of image characteristics of plaques in culprit coronary arteries by 64 slice CT and intravascular ultrasound in acute coronary syndromes

Hiroyuki Takaoka, Iwao Ishibashi, Masae Uehara, Geoffrey D. Rubin, Issei Komuro, Nobusada Funabashi

Research output: Contribution to journalArticlepeer-review

19 Scopus citations

Abstract

Purpose: To evaluate plaque image characteristics in coronary artery culprit-lesions in subjects with acute coronary syndromes (ACS), we retrospectively compared coronary arterial images by 64-slice CT before conventional-coronary-angiogram with those by intravascular ultrasound (IVUS). Materials-and-methods: Retrospective analysis of coronary arterial images from thirty-one subjects (26-males, mean age 59.3 ± 12.0 years) exhibiting acute symptoms with suspicion of ACS, where either (1) ECG was un-interpretable or (2) ECG was non diagnostic/cardiac biomarkers was equivocal; with significant stenosis on emergent 64 slice CT and subjects were finally diagnosed as having ACS confirmed by conventional-coronary-angiogram, followed by IVUS before coronary-intervention. After principal culprit-lesion components were classified into 1) thrombus, 2) soft plaques, and 3) fibrotic plaques by IVUS, corresponding culprit-lesion CT values were measured (two-observers). Results: Nineteen and 12 of 31 subjects were finally diagnosed as unstable angina pectoris and non-ST elevation acute myocardial infarction respectively. Main culprit-lesion components of ACS were identified on MSCT in all subjects. Culprit-lesion CT values diagnosed as soft plaques by IVUS (n = 6, 32.9 ± 8.7 HU) were not lower than those of thrombi (n = 18, 43.2 ± 10.7 HU, p = 0.268); both values were significantly lower than those of fibrotic plaques (n = 7, 82.5 ± 22.6 HU) (both p < 0.01). Calcification, spotty calcification, and positive arterial remodeling were observed in 67.7%, 61.3%, 58.1% (IVUS) and 58.1%, 51.6%, 74.2% (MSCT), respectively (all p = NS). CT value reproducibilities and culprit-lesion areas, were 0.87 and 0.86, respectively (two analyzers). Conclusions: 64-slice CT can non-invasively evaluate image characteristics in coronary artery culprit-lesions in ACS subjects accurately; this may help to differentiate soft plaques or thrombi generated by plaque rupture from fibrotic plaques.

Original languageEnglish (US)
Pages (from-to)119-126
Number of pages8
JournalInternational Journal of Cardiology
Volume160
Issue number2
DOIs
StatePublished - Oct 4 2012
Externally publishedYes

Keywords

  • 64 slice CT
  • Acute coronary syndromes
  • Image characteristics
  • Intravascular ultrasound
  • Plaques in culprit coronary arteries

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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