Plaque type and composition as evaluated non-invasively by MSCT angiography and invasively by VH IVUS in relation to the degree of stenosis
Plaque type and composition as evaluated non-invasively by MSCT angiography and invasively by VH IVUS in relation to the degree of stenosis
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DOI：
10.1136/hrt.2009.176933
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发表时间：
2009-12-15
期刊：
影响因子：
5.7
通讯作者：
Bax, J. J.
中科院分区：
文献类型：
--
作者：
van Velzen, J. E.;Schuijf, J. D.;Bax, J. J.
背景资料：冠状动脉斑块的成像传统上侧重于评估狭窄程度，因为不良心脏事件的风险随着狭窄程度的增加而增加。然而，斑块成分与狭窄程度之间的关系在很大程度上仍不清楚。目的：评估斑块成分方法：对78例患者行多层螺旋CT血管成像（MSCT）检查，并与血管内超声（VH IVUS）检查进行比较（识别三种斑块类型;非钙化、钙化、混合），然后进行侵入性冠状动脉造影和VH IVUS。VH IVUS评价斑块负荷、最小管腔面积和斑块组成（纤维化、纤维脂肪、坏死核心、致密钙），并将斑块分类为纤维钙化、纤维粥样硬化、薄帽纤维粥样硬化（TCFA）、病理性内膜增厚。对于每个斑块，通过定量冠状动脉造影评估狭窄百分比。结果：总的来说，43个斑块（19%）对应于显著狭窄。在分析的227个斑块中，MSCT显示70个为非钙化斑块（31%），96个为混合斑块（42%），61个为钙化斑块（27%）。MSCT上斑块类型在显著和非显著狭窄之间均匀分布。VH IVUS发现，严重狭窄的斑块具有更高的斑块负荷（67%（11%）vs 53%（12%），p
Background: Imaging of coronary plaques has traditionally focused on evaluating degree of stenosis, as the risk for adverse cardiac events increases with stenosis severity. However, the relation between plaque composition and severity of stenosis remains largely unknown.Objective: To assess plaque composition (non-invasively by multislice computed tomography (MSCT) angiography and invasively by virtual histology intravascular ultrasound (VH IVUS)) in relation to degree of stenosis.Methods: 78 patients underwent MSCT (identifying three plaque types; non-calcified, calcified, mixed) followed by invasive coronary angiography and VH IVUS. VH IVUS evaluated plaque burden, minimal lumen area and plaque composition (fibrotic, fibro-fatty, necrotic core, dense calcium) and plaques were classified as fibrocalcific, fibroatheroma, thin-capped fibroatheroma (TCFA), pathological intimal thickening. For each plaque, percentage stenosis was evaluated by quantitative coronary angiography. Significant stenosis was defined >50% stenosis.Results: Overall, 43 plaques (19%) corresponded to significant stenosis. Of the 227 plaques analysed, 70 were non-calcified plaques (31%), 96 mixed (42%) and 61 calcified (27%) on MSCT. Plaque types on MSCT were equally distributed among significant and non-significant stenoses. VH IVUS identified that plaques with significant stenosis had higher plaque burden (67% (11%) vs 53% (12%), p