Departments of Imaging (Division of Nuclear Medicine) and Medicine (Division of Cardiology), Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, S. Mark Taper Building, Suite 1258, Los Angeles, CA, 90048, USA.
Eur Radiol. 2013 Aug;23(8):2109-17. doi: 10.1007/s00330-013-2822-1. Epub 2013 Apr 4.
We evaluated the performance of manual measures of coronary plaque volumes and atherosclerotic plaque features from coronary CT angiography (CTA), using intravascular ultrasound (IVUS) as the reference.
Thirty individual coronary plaques with suitable fiduciary markers were identified. Plaque volumes on coronary CTA were manually quantified by two observers and compared to IVUS plaque volumes as interpreted by an independent laboratory. The presence of adverse plaque characteristics-low attenuation plaque (LAP), positive remodelling (PR) and spotty calcification (SC)-on coronary CTA was evaluated and compared to IVUS.
High correlation in plaque volumes was detected between observers (r = 0.94, P < 0.0001; 95 % limits of agreement <48.7 mm(3), bias 6.6 mm(3)). Excellent correlation (r = 0.95, P < 0.0001) was noted in plaque volume between independent observers and IVUS (95 % limits of agreement <40.6 mm(3), bias -4.4 mm(3)) and did not differ from IVUS (105.0 ± 56.7 vs. 109.4 ± 60.7 mm(3), P = 0.2). The frequency of LAP (10 % vs. 17 %), PR (7 % vs. 10 %) and SC (27 % vs. 33 %) was similar between coronary CTA and IVUS (all P = NS).
Plaque volume on coronary CTA determined by manual methods demonstrates high correlation and modest agreement to IVUS. Further, coronary CTA demonstrates high accuracy for the identification of adverse plaque characteristics, including LAP, PR and SC.
• Coronary CT angiography is a non-invasive test that enables coronary plaque assessment • Plaque quantification by coronary CT angiography correlates well with intravascular ultrasound findings • Coronary CT angiography can identify adverse plaque characteristics.
我们通过血管内超声（IVUS）作为参考，评估冠状动脉 CT 血管造影（CTA）中冠状动脉斑块体积的手动测量和动脉粥样硬化斑块特征的性能。
确定了 30 个具有合适参考标记的个体冠状动脉斑块。两名观察者手动定量冠状动脉 CTA 上的斑块体积，并将其与由独立实验室解释的 IVUS 斑块体积进行比较。评估冠状动脉 CTA 上的不良斑块特征（低衰减斑块[LAP]、正性重构[PR]和点状钙化[SC]）并与 IVUS 进行比较。
观察者之间在斑块体积上检测到高度相关性（r=0.94，P<0.0001；95%一致性界限<48.7mm3，偏差 6.6mm3）。独立观察者与 IVUS 之间的斑块体积相关性也非常好（r=0.95，P<0.0001）（95%一致性界限<40.6mm3，偏差-4.4mm3），与 IVUS 没有差异（105.0±56.7 与 109.4±60.7mm3，P=0.2）。LAP（10%比 17%）、PR（7%比 10%）和 SC（27%比 33%）的频率在冠状动脉 CTA 和 IVUS 之间相似（所有 P=NS）。
通过手动方法确定的冠状动脉 CTA 上的斑块体积与 IVUS 具有高度相关性和适度一致性。此外，冠状动脉 CTA 对识别 LAP、PR 和 SC 等不良斑块特征具有很高的准确性。
冠状动脉 CT 血管造影是一种可用于评估冠状动脉斑块的非侵入性检查。
冠状动脉 CT 血管造影的斑块定量与血管内超声结果相关性良好。
冠状动脉 CT 血管造影可识别不良斑块特征。
