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J Am Coll Cardiol, 2006; 47:40-47, doi:10.1016/j.jacc.2005.09.076
© 2006 by the American College of Cardiology Foundation
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Atherosclerotic Plaque Characterization by Multidetector Row Computed Tomography Angiography

Marco A.S. Cordeiro, MD, PhD*,{ddagger},a and João A.C. Lima, MD, MBA, FACC*,{dagger},a,*

* Division of Cardiology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland
{dagger} Division of Cardiology, Department of Radiology, The Johns Hopkins University School of Medicine, Baltimore, Maryland
{ddagger} Department of Cardiology, Heart Institute (InCor-DF), Zerbini Foundation, Brasilia, DF, Brazil


Figure 1
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  		Figure 1 Coronary 400/32 x 0.5-multidetector row computed tomography angiography (MDCTA) demonstrating a significant stenosis in proximal left anterior descending (red arrow), confirmed by quantitative coronary angiography as being equivalent to 85%. The same curved multiplanar reformatted image also shows a nonsignificant lesion in proximal right coronary artery (green arrow).

 

Figure 2
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  		Figure 2 (Left) Axial multidetector row computed tomographic (CT) image in a 55-year-old man shows calcium in left anterior descending. Agatston score was 318.6. (Right) Axial electron beam CT image obtained 18 days previously in the same subject. Agatston score was 234.1. Reproduced, with permission, from Stanford et al. (35).

 

Figure 3
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  		Figure 3 Coronary 400/64 x 0.5-multidetector row computed tomographic angiography depicting different types of atherosclerotic lesions (blue arrows = nonstenotic; yellow arrows = stenotic) in both left main and proximal to mid-left anterior descending. Courtesy of Toshiba Medical Systems Corporation.

 

Figure 4
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  		Figure 4 (A) Plaque volumes measured by 420/12 x 0.75-multidetector row computed tomographic angiography and intravascular ultrasound (IVUS), with a relatively good correlation (r = 0.8, p < 0.001) between them. (B) However, the Bland-Altman analysis showed that 420/12 x 0.75-MDCTA systematically underestimates plaque volumes (mean difference = 19 mm3) when compared to IVUS. Reproduced, with permission, from Achenbach et al. (51).

 

Figure 5
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  		Figure 5 Positive remodeling of a non-calcified plaque proximally located in the right coronary artery (yellow arrows) as depicted by 400/16 x 0.5-multidetector row computed tomographic angiography. Outward expansion of the arterial wall can be seen in both curved multiplanar reformatted (left) and cross-sectional (right) images.

 

Figure 6
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  		Figure 6 A 60-year-old man presents to the emergency department with chest pain. An axial multidetector row computed tomographic angiography image clearly shows a thrombus in the right middle lobe pulmonary artery (arrow). Reproduced, with permission, from White et al. (66).

 

Figure 7
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  		Figure 7 Proximal to mid-left anterior descending in-stent restenosis (yellow arrows) as depicted by 400/64 x 0.5-multidetector row computed tomographic angiography.

 

Figure 8
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  		Figure 8 Peripheral 400/32 x 0.5-multidetector row computed tomographic angiography depicting a 3D representation of an occluded left common iliac artery (red arrows) proximal to its bifurcation. The distal territory, including both external (yellow arrow) and internal (blue arrow) iliac arteries, is entirely supplied by collateral flow from the left inferior epigastric artery (green arrow). A calcified nonstenotic atherosclerotic plaque can also be seen in the right common iliac artery (purple arrow). Abdominal pellets from a previous gunshot wound are also visible.

 




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