Nakanishi Rine, Alani Anas, Matsumoto Suguru, Li Dong, Fahmy Michael, Abraham Jeby, Dailing Christopher, Broersen Alexander, Kitslaar Pieter H, Nasir Khurram, Min James K, Budoff Matthew J
Tex Heart Inst J. 2018 Apr 7;45(2):84-91. doi: 10.14503/THIJ-15-5212. eCollection 2018 Apr.
Serial measurements of coronary plaque volume have been used to evaluate drug efficacy in atherosclerotic progression. However, the usefulness of computed tomography for this purpose is unknown. We investigated whether the change in total plaque volume on coronary computed tomographic angiography is associated with the change in segment plaque volume on intravascular ultrasound. We prospectively enrolled 11 consecutive patients (mean age, 56.3 ± 5 yr; 6 men) who were to undergo serial invasive coronary angiographic examinations with use of grayscale intravascular ultrasound and coronary computed tomography, performed <180 days apart at baseline and from 1 to 2 years later. Subjects underwent 186 serial measurements of total plaque volume on coronary computed tomography and 22 of segmental plaque volume on intravascular ultrasound. We used semiautomated software to examine percentage relationships and changes between total plaque and segmental plaque volumes. No significant correlations were found between percentages of total coronary and segment coronary plaque volume, nor between normalized coronary plaque volume. However, in the per-patient analysis, there were strong correlations between the imaging methods for changes in total coronary and segment coronary plaque volume (=0.62; =0.04), as well as normalized plaque volume (=0.82; =0.002). Per-patient change in plaque volume on coronary computed tomography is significantly associated with that on intravascular ultrasound. Computed tomographic angiography may be safer and more widely available than intravascular ultrasound for evaluating atherosclerotic progression in coronary arteries. Larger studies are warranted.
冠状动脉斑块体积的系列测量已被用于评估药物在动脉粥样硬化进展中的疗效。然而，计算机断层扫描在此目的上的实用性尚不清楚。我们研究了冠状动脉计算机断层血管造影上总斑块体积的变化是否与血管内超声上节段斑块体积的变化相关。我们前瞻性地纳入了11例连续患者（平均年龄56.3±5岁；6例男性），这些患者将接受使用灰阶血管内超声和冠状动脉计算机断层扫描的系列有创冠状动脉血管造影检查，在基线时以及1至2年后相隔<180天进行。受试者接受了186次冠状动脉计算机断层扫描上总斑块体积的系列测量以及22次血管内超声上节段斑块体积的测量。我们使用半自动软件来检查总斑块和节段斑块体积之间的百分比关系和变化。在冠状动脉总斑块和节段斑块体积的百分比之间，以及标准化冠状动脉斑块体积之间，均未发现显著相关性。然而，在按患者分析中，两种成像方法在冠状动脉总斑块和节段斑块体积变化方面存在强相关性（=0.62；=0.04），在标准化斑块体积方面也存在强相关性（=0.82；=0.002）。冠状动脉计算机断层扫描上斑块体积的按患者变化与血管内超声上的变化显著相关。对于评估冠状动脉粥样硬化进展，计算机断层血管造影可能比血管内超声更安全且更广泛可用。需要进行更大规模的研究。
