Cademartiri Filippo, La Grutta Ludovico, Palumbo Anselmo Alessandro, Maffei Erica, Runza Giuseppe, Bartolotta Tommaso Vincenzo, Pugliese Francesca, Mollet Nico R A, Midiri Massimo, Krestin Gabriel P
Department of Radiology, Erasmus Medical Center, 3015 GD-Rotterdam, The Netherlands.
Eur Radiol. 2006 Nov;16 Suppl 7:M44-53. doi: 10.1007/s10406-006-0195-0.
The composition of an atherosclerotic lesion, rather than solely the degree of stenosis, is considered to be an important determinant of acute coronary events. Whereas until recently only invasive techniques have been able to provide clues about plaque composition with consistent reproducibility, several recent studies have revealed the potential of multislice computed tomography (MSCT) for noninvasive plaque imaging. Coronary MSCT has the potential to detect coronary plaques and to characterize their composition based on the X-ray attenuating features of each structure. MSCT may also reveal the total plaque burden (calcified and noncalcified components) for individual patients with coronary atherosclerosis. However, several parameters (i.e. lumen attenuation, convolution filtering, body mass index of the patient, and contrast to noise ratio of the images) are able to modify the attenuation values that are used to define the composition of coronary plaques. The detection of vulnerable plaques will require more sophisticated scanners combined with newer software applications able to provide quantitative information. The aim of this article is to discuss the potential benefits and limitations of MSCT in coronary plaque imaging.
动脉粥样硬化病变的组成，而非仅仅是狭窄程度，被认为是急性冠脉事件的一个重要决定因素。直到最近，只有侵入性技术能够以一致的可重复性提供有关斑块组成的线索，但最近的几项研究揭示了多层螺旋计算机断层扫描（MSCT）在无创斑块成像方面的潜力。冠状动脉MSCT有潜力检测冠状动脉斑块，并根据每个结构的X线衰减特征对其组成进行表征。MSCT还可以揭示个体冠状动脉粥样硬化患者的总斑块负荷（钙化和非钙化成分）。然而，几个参数（即管腔衰减、卷积滤波、患者体重指数以及图像的对比噪声比）能够改变用于定义冠状动脉斑块组成的衰减值。检测易损斑块将需要更先进的扫描仪与能够提供定量信息的更新软件应用程序相结合。本文的目的是讨论MSCT在冠状动脉斑块成像中的潜在益处和局限性。
