Schmid Michael, Achenbach Stephan, Ropers Dieter, Komatsu Sei, Ropers Ulrike, Daniel Werner G, Pflederer Tobias
Department of Internal Medicine II, University of Erlangen, Erlangen, Germany.
Am J Cardiol. 2008 Mar 1;101(5):579-84. doi: 10.1016/j.amjcard.2007.10.016. Epub 2007 Dec 21.
Multidetector computed tomography (MDCT) permits the visualization of the coronary arteries and of coronary atherosclerotic plaques. The natural course of noncalcified plaque is not known. This study was conducted to measure the change in noncalcified coronary plaque volume in the left main coronary artery and in the proximal left anterior descending coronary artery over time using 64-slice MDCT. Fifty patients in whom noncalcified lesions had been detected on baseline MDCT received follow-up scans after an interval of 17 +/- 6 months. Plaque areas were traced manually in serial multiplanar reconstructions to determine overall volume. The mean plaque volumes were 92 +/- 81 mm(3) on baseline MDCT and 115 +/- 110 mm(3) on follow-up MDCT (p <0.001). The mean annualized volume change was 22% (95% confidence interval 14.7% to 29.7%). A weak but significant correlation with low-density lipoprotein cholesterol level was observed for the amount of baseline plaque volume (r = 0.37, p <0.001). In conclusion, the quantification of noncalcified plaque volume is possible on repeated 64-slice MDCT. A significant increase of the amount of noncalcified plaque was observed over a mean interval of 17 months. Contrast-enhanced MDCT may therefore be a tool to study the progression of coronary atherosclerosis.
多层螺旋计算机断层扫描（MDCT）能够显示冠状动脉及冠状动脉粥样硬化斑块。非钙化斑块的自然病程尚不清楚。本研究旨在使用64层MDCT测量左冠状动脉主干及左前降支近端非钙化冠状动脉斑块体积随时间的变化。50例在基线MDCT上检测到非钙化病变的患者在间隔17±6个月后接受了随访扫描。在系列多平面重建中手动描绘斑块面积以确定总体积。基线MDCT时平均斑块体积为92±81mm³，随访MDCT时为115±110mm³（p<0.001）。平均年化体积变化为22%（95%置信区间14.7%至29.7%）。观察到基线斑块体积与低密度脂蛋白胆固醇水平存在弱但显著的相关性（r=0.37，p<0.001）。总之，在重复的64层MDCT上对非钙化斑块体积进行量化是可行的。在平均17个月的时间间隔内观察到非钙化斑块数量显著增加。因此，对比增强MDCT可能是研究冠状动脉粥样硬化进展的一种工具。
