Cordeiro Marco A S, Lima João A C
Division of Cardiology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
J Am Coll Cardiol. 2006 Apr 18;47(8 Suppl):C40-7. doi: 10.1016/j.jacc.2005.09.076.
Multidetector row computed tomography angiography (MDCTA) is seen as a potential alternative to current imaging methods for the assessment of vessel anatomy and atherosclerotic plaque composition/morphology in a great variety of arterial beds. Recent advances represented by the increase in gantry speed to <500 ms per rotation and in the number of detector rows from 4 to 64, in addition to the decrease in slice thickness to submillimetric levels, brought significant improvement in diagnostic accuracy by coronary MDCTA. In general, it has a good correlation with both intravascular ultrasound (IVUS) and histopathology for discrimination between soft, intermediate, and calcified plaques. Plaque area and volume tend to be underestimated by 12-detector row MDCTA and overestimated by 16-detector row MDCTA, but the number of patients studied so far is relatively small. However, it seems that 64-detector row MDCTA can measure plaque area and volume with greater accuracy. Plaque remodeling is overestimated in small vessels by 12-detector row MDCTA, whereas 16- and 64-detector row MDCTA show a good correlation with IVUS. Although still under development, the potential of MDCTA to characterize atherosclerotic plaque composition as well as to precisely determine plaque area, volume, and remodeling in the future is quite promising.
多排螺旋计算机断层血管造影（MDCTA）被视为一种潜在的替代当前成像方法，用于评估多种动脉床的血管解剖结构和动脉粥样硬化斑块的组成/形态。以机架旋转速度提高到每旋转<500毫秒以及探测器排数从4排增加到64排为代表的最新进展，除了层厚减小到亚毫米水平外，还使冠状动脉MDCTA的诊断准确性有了显著提高。总体而言，它与血管内超声（IVUS）和组织病理学在区分软斑块、中等斑块和钙化斑块方面都有良好的相关性。12排探测器的MDCTA往往会低估斑块面积和体积，而16排探测器的MDCTA则会高估，但迄今为止研究的患者数量相对较少。然而，64排探测器的MDCTA似乎能够更准确地测量斑块面积和体积。12排探测器的MDCTA会高估小血管中的斑块重塑，而16排和64排探测器的MDCTA与IVUS显示出良好的相关性。尽管仍在发展中，但MDCTA在未来表征动脉粥样硬化斑块组成以及精确确定斑块面积、体积和重塑方面的潜力非常可观。
