Quantification of Non-Calcified and Calcified Coronary Plaques Using 64- Slice MDCT in Patients with Acute Coronary Syndrome

摘要

Purpose: To investigate the accuracy of 64-row MDCT to analyze and quantify coronary arterial plaques in patients presented with acute coronary syndrome (ACS). Patients and methods: Between April 2010 and December 2013, 50 patients presented with acute cardiac chest pain were categorized into 2 groups according to their diagnosis based on clinical evaluation, ECG findings and cardiac biomarkers; group A including patients with ACS and group B including patients with stable angina (SA). Both groups underwent 64-row multidetector CT (MDCT) coronary arterial imaging. For each plaque, stenosis percentage was evaluated and the plaque was quantified using software (Sureplaque?) based on the density (HU) and percentage of its individual components including lipid, soft tissue, and calcium density. Results: Of the 50 patients; 24 and 26 were grouped into groups A & B respectively. The mean value of stenosis percent of the proximal & middle coronary segments of group A patients = 77.2% ± 10.2% - 90.5% ± 58.4% and 79.5% ± 9.1% - 85.25% ± 11% respectively, while in group B = 54.1% ± 12.1% - 65.2% ± 18.4% & 53.3% ± 1.5% - 68.6% ± 11.7% respectively (p=0.00-0.001). Quantification showed a mean value of lipid content percentage of group A = 15.4% ± 0.8% - 47.7 % ± 19.2 %, while in group B = 7.2% ± 5.5% - 10.3% ± 8.2% (p=0.008-0.001). The mean value of soft tissue content percentage in group A = 15.4% ± 0.8% - 47.7 % ± 19.2 %, while in group B = 7.2% ±5.5% - 10.3% ± 8.2%. The calcification content percentage in group A = 18% ± 8.7% - 35.1 % ± 16 %, while in group B = 66.4% ± 13.8% - 76.7% ± 16.5%. Conclusion: 64-row MDCT angiographic quantification software provides a good basis for the future attempts of proper risk stratification of patients with coronary artery disease especially those liable for developing ACS