Characterization of Coronary Atherosclerotic Plaques by Multidetector Computed Tomography

Characterization of coronary atherosclerosis by dual-source computed tomography and HU-based color mapping: a pilot study

“…In doing so, we found markedly higher HU ranges for fibrous plaque than earlier reported in the literature [16,20,29]. Interestingly, our results are in agreement with more recent comparisons of MSCT to IVUS [21][22][23]. Arguably, variations in spatial resolution of scanners, radiation dose application and maximal luminal attenuation exert a considerable effect on thresholds for such tissues that are in close proximity and have similar CT densities to the enhancing vessel lumen.…”

“…Another important reason lies with the as yet limited spatial resolution of DSCT, which is certainly insufficient to dissect the complexity of plaque morphology. As frequently been demonstrated for fatty and fibrous plaque components, partial volume effects result in a considerable overlap of density values [16,[20][21][22][23]. Moreover, all of our plaques displayed a relatively homogeneous composition.…”

“…Hence, CT density values have not primarily been employed in quantification and characterization of atheroma, but have only been retrospectively measured in visually detected plaque components [16,[20][21][22][23].…”

“…However, until now, its capacity to accurately quantify and characterize the non-calcified plaque has been restricted by limited temporal and spatial resolution. While Hounsfield units (HU) have been proven to be significantly different for the various plaque components, partial volume effects have restricted a prospective use of CT attenuation in the classification of atheroma [16,[20][21][22][23][24]. Therefore, in MSCT, segmentation of plaque was previously done by visual assessment and manual contouring.…”

Myocardial CT perfusion imaging for ischemia detection

“…CCTA has the ability to evaluate the lumen as well as the vessel wall, thereby having the ability to characterize the atherosclerotic plaques that are generating stenosis (15)(16)(17). In the past year, a reporting and data system document known as Coronary Artery Disease Reporting and Data System ( CAD-RADS TM ) (18) was published, aimed to standardize the communication of CCTA findings in order to facilitate decision-making according to the results that helps for further management.…”