Skip to main content

Plaque Morphology Evaluation by CT

  • Chapter
  • First Online:
Practical Textbook of Cardiac CT and MRI
  • 3057 Accesses

Abstract

Noninvasive imaging tools that allow reliable determination of plaque burden and plaque composition are important for risk stratification and monitoring of coronary atherosclerosis. Coronary computed tomographic angiography (CCTA) has tremendous potential to provide uniquely valuable information concerning coronary atherosclerosis. Beyond the detection of coronary artery stenosis, CCTA can demonstrate coronary atherosclerotic plaque. Certain plaque characteristics, such as positive remodeling or very low CT attenuation, are associated with plaque vulnerability. In this chapter, an overview of CT imaging with a focus on the characterization of coronary artery plaque will be highlighted. In addition, limitations and future directions of CT imaging on coronary artery plaque characterization will be discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Mintz GS, Nissen SE, Anderson WD, et al. American College of Cardiology clinical expert consensus document on standards for acquisition, measurement and reporting of intravascular ultrasound studies (IVUS): a report of the American College of Cardiology Task Force on Clinical Expert Consensus Documents. J Am Coll Cardiol. 2001;37:1478–92.

    Article  CAS  PubMed  Google Scholar 

  2. Nair A, Kuban BD, Tuzcu EM, Schoenhagen P, Nissen SE, Vince DG. Coronary plaque classification with intravascular ultrasound radiofrequency data analysis. Circulation. 2002;106:2200–6.

    Article  PubMed  Google Scholar 

  3. Nasu K, Tsuchikane E, Katoh O, et al. Accuracy of in vivo coronary plaque morphology assessment: a validation study of in vivo virtual histology compared with in vitro histopathology. J Am Coll Cardiol. 2006;47:2405–12.

    Article  PubMed  Google Scholar 

  4. Schoepf UJ, Zwerner PL, Savino G, Herzog C, Kerl JM, Costello P. Coronary CT angiography. Radiology. 2007;244:48–6.

    Article  PubMed  Google Scholar 

  5. Cordeiro MA, Lima JA. Atherosclerotic plaque characterization by multidetector row computed tomography angiography. J Am Coll Cardiol. 2006;47(8 Suppl):C40–7.

    Article  PubMed  Google Scholar 

  6. Spuentrup E, Botnar RM. Coronary magnetic resonance imaging: visualization of the vessel lumen and the vessel wall and molecular imaging of arteriothrombosis. Eur Radiol. 2006;16:1–14.

    Article  PubMed  Google Scholar 

  7. Finn AV, Nakano M, Narula J, Kolodgie FD, Virmani R. Concept of vulnerable/unstable plaque. Arterioscler Thromb Vasc Biol. 2010;30:1282–92.

    Article  CAS  PubMed  Google Scholar 

  8. Naghavi M, Libby P, Falk E, et al. From vulnerable plaque to vulnerable patient: a call for new definitions and risk assessment strategies: part I. Circulation. 2003;108:1664–72.

    Article  PubMed  Google Scholar 

  9. Leber AW, Knez A, von Ziegler F, et al. Quantification of obstructive and nonobstructive coronary lesions by 64-slice computed tomography: a comparative study with quantitative coronary angiography and intravascular ultrasound. J Am Coll Cardiol. 2005;46:147–54.

    Article  PubMed  Google Scholar 

  10. Leber AW, Becker A, Knez A, et al. Accuracy of 64-slice computed tomography to classify and quantify plaque volumes in the proximal coronary system: a comparative study using intravascular ultrasound. J Am Coll Cardiol. 2006;47:672–7.

    Article  PubMed  Google Scholar 

  11. Achenbach S, Moselewski F, Ropers D, et al. Detection of calcified and noncalcified coronary atherosclerotic plaque by contrast-enhanced, submillimeter multidetector spiral computed tomography: a segment based comparison with intravascular ultrasound. Circulation. 2004;109:14–7.

    Article  PubMed  Google Scholar 

  12. Schroeder S, Kopp AF, Baumbach A, et al. Noninvasive detection and evaluation of atherosclerotic coronary plaques with multi-slice computed tomography. J Am Coll Cardiol. 2001;37:1430–5.

    Article  CAS  PubMed  Google Scholar 

  13. Leber AW, Knez A, Becker A, et al. Accuracy of multi-detector spiral computed tomography in identifying and differentiating the composition of coronary atherosclerotic plaques: a comparative study with intracoronary ultrasound. J Am Coll Cardiol. 2004;43:1241–7.

    Article  PubMed  Google Scholar 

  14. Pohle K, Achenbach S, Macneill B, et al. Characterization of non-calcified coronary atherosclerotic plaque by multi-detector row CT: comparison to IVUS. Atherosclerosis. 2007;190:174–80.

    Article  CAS  PubMed  Google Scholar 

  15. Hur J, Kim YJ, Lee HJ, et al. Quantification and characterization of obstructive coronary plaques using 64-slice computed tomography: a comparison with intravascular ultrasound. J Comput Assist Tomogr. 2009;33:186–92.

    Article  PubMed  Google Scholar 

  16. Varnava AM, Mills PG, Davies MJ. Relationship between coronary artery remodeling and plaque vulnerability. Circulation. 2002;105:939–43.

    Article  PubMed  Google Scholar 

  17. Narula J, Achenbach S. Napkin-ring necrotic cores: defining circumferential extent of necrotic cores in unstable plaques. JACC Cardiovasc Imaging. 2009;2:1436–8.

    Article  PubMed  Google Scholar 

  18. Kashiwagi M, Tanaka A, Kitabata H, et al. Feasibility of noninvasive assessment of thin-cap fibroatheroma by multidetector computed tomography. JACC Cardiovasc Imaging. 2009;2:1412–9.

    Article  PubMed  Google Scholar 

  19. Carrigan TP, Nair D, Schoenhagen P, et al. Prognostic utility of 64-slice computed tomography in patients with suspected but no documented coronary artery disease. Eur Heart J. 2009;30:362–71.

    Article  PubMed  Google Scholar 

  20. Chow BJ, Wells GA, Chen L, et al. Prognostic value of 64-slice cardiac computed tomography severity of coronary artery disease, coronary atherosclerosis, and left ventricular ejection fraction. J Am Coll Cardiol. 2010;55:1017–28.

    Article  PubMed  Google Scholar 

  21. Motoyama S, Sarai M, Harigaya H, et al. Computed tomographic angiography characteristics of atherosclerotic plaques subsequently resulting in acute coronary syndrome. J Am Coll Cardiol. 2009;54:49–57.

    Article  PubMed  Google Scholar 

  22. Choi EK, Choi SI, Rivera JJ, et al. Coronary computed tomography angiography as a screening tool for the detection of occult coronary artery disease in asymptomatic individuals. J Am Coll Cardiol. 2008;52:357–65.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jin Hur .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Hur, J., Choi, B.W. (2015). Plaque Morphology Evaluation by CT. In: Lim, TH. (eds) Practical Textbook of Cardiac CT and MRI. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-36397-9_6

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-36397-9_6

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-36396-2

  • Online ISBN: 978-3-642-36397-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics