Flat-panel versus 64-channel computed tomography for in vivo quantitative characterization of aortic atherosclerotic plaques

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• 作者：Ibrahim Aboshady^a ; ^b ; ^{IAboshady@heart.thi.tmc.edu} ; Dianna D. Cody^c ; Evan M. Johnson^b ; Amir Gahremanpour^a ; Deborah Vela^a ; ^b ; Kamal G. Khalil^b ; ^d ; Herbert L. DuPont^a ; ^b ; ^d ; James T. Willerson^a ; ^b ; L. Maximilian Buja^a ; ^b ; Gregory W. Gladish^c
• 关键词：Aorta ; Atherosclerosis ; Cardiovascular imaging ; Computed tomography ; Vulnerable plaque
• 刊名：International Journal of Cardiology
• 出版年：2012
• 期刊代码：128_01675273
• 类别：med
• 出版时间：3 May, 2012
• 卷：156
• 期：3
• 页码：295-302
• 文件大小：1214 K

摘要

Background

Flat-panel computed tomography (FpCT) provides better spatial resolution than 64-channel CT (64-CT) and may improve in vivo quantitative assessment of atherosclerotic plaques.

Methods and results

Lesions in 184 aortic histology sections from 6 Watanabe heritable hyperlipidemic rabbits were quantitatively compared with 64-CT (image thickness, 0.625 mm) and FpCT (image thickness, 0.150 mm) images. Images were re-oriented perpendicular to the vessel centerline. For detecting plaque, FpCT and 64-CT were not significantly different (sensitivity, 76%vs 66%; P = NS). Although FpCT was significantly more sensitive (42%vs 0%; P = < 0.001) for detecting eccentric lesions, the area under the curve (AUC) for FpCT (0.6) was not significantly different from that for 64-CT (0.45; P = NS). In detecting plaques with 鈮?#xA0;10%lipid (low attenuation foci), FpCT was significantly more sensitive than 64-CT (24%vs 0.7%; P < 0.00) and had a significantly greater AUC (0.6 vs 0.5; P < 0.006). Additionally, FpCT was more sensitive (65%vs 0%; P < 0.00) in detecting plaques with 鈮?#xA0;5%calcium (high attenuation foci) but not in detecting branch points. Both FpCT and histology allowed us to detect low-attenuation foci as small as 0.3 mm in diameter, whereas 64-CT allowed us to detect only low-attenuation foci 鈮?#xA0;1.5 mm in diameter.

Conclusions

Flat-panel CT seemed to have more potential for quantitatively screening low-risk small atherosclerotic lesions, whereas 64-CT was apparently more useful when imaging established, well-characterized lesions, particularly when measuring the vascular wall thickness in a rabbit model of atherosclerosis.