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Accuracy of multidetector spiral computed tomography in identifying and differentiating the composition of coronary atherosclerotic plaques

A comparative study with intracoronary ultrasound

Alexander W. Leber, MD^*,*, Andreas Knez, MD^*, Alexander Becker, MD^*, Christoph Becker, MD, Franz von Ziegler, MD^*, Konstantin Nikolaou, MD, Carsten Rist, MD, Maximilian Reiser, MD, Carl White, MD, Gerhard Steinbeck, MD^* and Peter Boekstegers, MD^*

^* Department of Cardiology, University of Munich, Munich, Germany
Institute for Diagnostic Radiology, Klinikum Grosshadern, University of Munich, Munich, Germany
Division of Cardiology, University of Minnesota, Minneapolis, Minnesota, USA

View larger version (122K): [in a new window]   Figure 1 For analysis of intracoronary ultrasound (ICUS) and multidetector computer tomography (MDCT) data, the coronary arteries were divided into 3-mm sections. White lines indicate 3-mm intervals of the right coronary artery (RCA) in the longitudinal view of ICUS (D) and MDCT (B). (A) Axial MDCT view of a calcified plaque. (B) Longitudinal MDCT view of the RCA containing a partly calcified and noncalcified plaque; the level of image A is indicated by the white line. (C) Corresponding axial ICUS view. (D) Longitudinal ICUS view of the RCA; the level of the axial image C is indicated by the arrow.

View larger version (23K): [in a new window]   Figure 2 Computed tomography (CT) density values for hypoechoic, hyeperechoic, and calcified plaques. Each box describes the distribution of density values within one SD. The whiskers above and below each box are describing the range between the lowest and highest observed density value. The differences of the mean CT density values between hypoechoic, hyperechoic, and calcified plaques were significant with a p value <0.02.

View larger version (145K): [in a new window]   Figure 3 Corresponding longitudinal and axial intracoronary ultrasound (ICUS) and multidetector computer tomography (MDCT) images. (A) Intracoronary ultrasound of a left anterior descending artery in longitudinal direction containing a hypoechoic plaque adjacent to a stent. (B) Corresponding MDCT reconstruction using maximum intensity projection. (C) Axial tomographic view of the hypoechoic plaque on the level of the arrow in image A. (D) Same plaque in axial view using multiplanar reformatted MDCT data.