Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Eur Radiol. 2018 Feb;28(2):833-843. doi: 10.1007/s00330-017-4992-8. Epub 2017 Aug 23.
OBJECTIVES: To evaluate whether plaque characteristics as assessed by coronary computed tomography angiography (CCTA) were associated with the presence of a thin-cap fibroatheroma (TCFA)-a precursor of plaque rupture-defined by optical coherence tomography (OCT) in a section-to-section-level comparison. METHODS: From 28 symptomatic patients, 31 coronary lesions were evaluated on 727 cross-sections co-registered by both CCTA and OCT. CCTA plaque characteristics included low attenuation plaque (LAP, <30 HU), napkin ring sign (NRS), positive remodelling (PR, remodelling index ≥1.10), and spotty calcification and plaque area and plaque burden. By OCT, presence of TCFA, lumen area and arc of lipid were determined. RESULTS: OCT revealed a TCFA in 69 (9.4%) sections from 19 (61.2 %) lesions. In per-section analysis, OCT-TCFA showed higher frequency of CCTA-detected LAP (58.0% vs. 18.5%), NRS (31.9% vs. 8.8%) and PR (68.1% vs. 48.0%) and greater plaque burden (70.6% vs. 61.9%) as compared to sections without OCT-TCFA (all p < 0.05). In multivariable analysis, LAP (odds ratio [OR] 4.05, p < 0.001) and NRS (OR 2.47, p = 0.005) were associated with OCT-TCFA. CCTA-measured lumen area correlated well with OCT-measured lumen area (R = 0.859, limits of agreement -0.5 ± 3.7 mm). CONCLUSIONS: LAP and NRS in CCTA were associated with the presence of OCT-defined TCFA in a section-to-section comparison. KEY POINTS: • CT-defined LAP and NRS were associated with OCT-defined TCFA • OCT-TCFA showed higher frequency of LAP, NRS, PR and greater plaque burden • Non-calcified plaque area was correlated with OCT-measured lipid arc.
目的：通过冠状动脉计算机断层扫描血管造影术（CCTA）评估斑块特征，与光学相干断层扫描（OCT）定义的薄帽纤维粥样瘤（TCFA）——斑块破裂的前兆——在节段水平进行比较，观察两者是否存在相关性。
方法：在 28 例有症状的患者中，共评估了 31 个冠状动脉病变，这些病变通过 CCTA 和 OCT 共定位了 727 个横截面。CCTA 斑块特征包括低衰减斑块（LAP，＜30 HU）、餐巾环征（NRS）、正性重构（PR，重构指数≥1.10）、点状钙化以及斑块面积和斑块负荷。通过 OCT 确定存在 TCFA、管腔面积和脂质弧形。
结果：OCT 显示 19 个（61.2%）病变的 69 个（9.4%）节段存在 TCFA。在节段分析中，与没有 OCT-TCFA 的节段相比，OCT-TCFA 节段更常出现 CCTA 检测到的 LAP（58.0%比 18.5%）、NRS（31.9%比 8.8%）和 PR（68.1%比 48.0%），以及更大的斑块负荷（70.6%比 61.9%）（所有 P＜0.05）。多变量分析显示，LAP（比值比[OR] 4.05，P＜0.001）和 NRS（OR 2.47，P=0.005）与 OCT-TCFA 相关。CCTA 测量的管腔面积与 OCT 测量的管腔面积相关性良好（R=0.859，一致性界限-0.5±3.7 mm）。
结论：在节段比较中，CCTA 测量的 LAP 和 NRS 与 OCT 定义的 TCFA 存在相关性。
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