Dose napkin-ring sign suggest possibility to identify rupture-prone plaque in coronary computed tomography angiography?

摘要

"Napkin-ring sign," which is also called "ring-like sign" (Fig. 1), represents a lesion with a central low-attenuation area with circumferential high attenuation open ring area in cross-sectional images of coronary computed tomography angiography (CCTA) [ 1 ]. This is correspondent with a thin-capped fibroatheroma which is recognized as a precursor lesion for plaque rupture. Kashiwagi et al. [2] enrolled 273 patients with acute coronary syndrome (n = 61) or stable angina (n = 212) who underwent CCTA. In the present paper,the authors defined the napkin-ring sign lesions as the presence of ring of high attenuation and the CT attenuation of a ring presenting higher than those of the adjacent plaque and no greater than 130 Hounsfield units (HU). Napkin-ring sign at the culprit lesions was more frequently observed (12.7% vs. 2.8%, p<0.01).