ABSTRACT
Multislice detector spiral computed tomography (MSCT) is a noninvasive modality for
visualization and evaluation of atherosclerosis in vivo in different arterial beds.
Rapid technical advances led to a significant improvement of the diagnostic accuracy
of coronary MSCT angiography. The most popular clinical application with best scientific
Medical evidence of MSCT is the noninvasive detection and quantification of coronary
calcifications. In particular, the concept of determining coronary artery age by evaluating
an individual's biological age, rather than his or her chronological age, is attractive
and currently under scientific evaluation. In addition to evaluating contrast-enhanced
coronary arteries, different stages of atherosclerosis can be visualized. By comparative
studies with intracoronary ultrasound, it could be shown that echogenicity corresponds
well with the density measured within atherosclerotic plaques expressed by Hounsfield
units using MSCT. Although the method is improving continuously and is still under
development, the potential of MSCT to evaluate plaque composition and plaque volumes
noninvasively in vivo is promising.
KEYWORDS
Coronary artery disease - plaque imaging - multislice detector spiral computed tomography
(MSCT) - calcium score
REFERENCES
- 1
Naghavi M, Libby P, Falk E et al..
From vulnerable plaque to vulnerable patient: a call for new definitions and risk
assessment strategies. Part II.
Circulation.
2003;
108
1772-1778
- 2
Naghavi M, Libby P, Falk E et al..
From vulnerable plaque to vulnerable patient: a call for new definitions and risk
assessment strategies. Part I.
Circulation.
2003;
108
1664-1672
- 3
Naghavi M, Falk E, Hecht H S et al..
From vulnerable plaque to vulnerable patient-Part III: executive summary of the Screening
for Heart Attack Prevention and Education (SHAPE) Task Force Report.
Am J Cardiol.
2006;
98
2-15
- 4
Beck T, Burgstahler C, Reimann A et al..
Technology insight: possible applications of multislice computed tomography in clinical
cardiology.
Nat Clin Pract Cardiovasc Med.
2005;
2
361-368
- 5
Kopp A F, Heuschmid M, Reimann A et al..
Evaluation of cardiac function and myocardial viability with 16- and 64-slice multidetector
computed tomography.
Eur Radiol.
2005;
15(suppl 4)
D15-D20
- 6
Johnson T R, Nikolaou K, Wintersperger B J et al..
Dual-source CT cardiac imaging: initial experience.
Eur Radiol.
2006;
16
1409-1415
- 7
Kuettner A, Beck T, Drosch T et al..
Image quality and diagnostic accuracy of non-invasive coronary imaging with 16 detector
slice spiral computed tomography with 188 ms temporal resolution.
Heart.
2005;
91
938-941
- 8
Mollet N R, Cademartiri F, van Mieghem C A et al..
High-resolution spiral computed tomography coronary angiography in patients referred
for diagnostic conventional coronary angiography.
Circulation.
2005;
112
2318-2323
- 9
Ohnesorge B, Flohr T, Fischbach R et al..
Reproducibility of coronary calcium quantification in repeat examinations with retrospectively
ECG-gated multisection spiral CT.
Eur Radiol.
2002;
12
1532-1540
- 10
Arad Y, Goodman K J, Roth M et al..
Coronary calcification, coronary disease risk factors, C-reactive protein, and atherosclerotic
cardiovascular disease events: the St. Francis Heart Study.
J Am Coll Cardiol.
2005;
46
158-165
- 11
Raggi P, Taylor A, Fayad Z et al..
Atherosclerotic plaque imaging: contemporary role in preventive cardiology.
Arch Intern Med.
2005;
165
2345-2353
- 12
Raggi P.
Noninvasive imaging of atherosclerosis among asymptomatic individuals.
Arch Intern Med.
2006;
166
1068-1071
- 13
Vliegenthart R, Oudkerk M, Hofman A et al..
Coronary calcification improves cardiovascular risk prediction in the elderly.
Circulation.
2005;
112
572-577
- 14
Raggi P.
Prognostic implications of absolute and relative calcium scores.
Herz.
2001;
26
252-259
- 15
Schisterman E F, Whitcomb B W.
Coronary age as a risk factor in the modified Framingham risk score.
BMC Med Imaging.
2004;
4
1
- 16
Shaw L J, Raggi P, Berman D S et al..
Coronary artery calcium as a measure of biologic age.
Atherosclerosis.
2005;
188
112-119
- 17
De Backer G, Ambrosioni E, Borch-Johnsen K et al..
European guidelines on cardiovascular disease prevention in clinical practice. Third
Joint Task Force of European and Other Societies on Cardiovascular Disease Prevention
in Clinical Practice.
Eur Heart J.
2003;
24
1601-1610
- 18
Schroeder S, Flohr T, Kopp A F et al..
Accuracy of density measurements within plaques located in artificial coronary arteries
by X-ray multislice CT: results of a phantom study.
J Comput Assist Tomogr.
2001;
25
900-906
- 19
Schroeder S, Kopp A F, Baumbach A et al..
Noninvasive detection and evaluation of atherosclerotic coronary plaques with multislice
computed tomography.
J Am Coll Cardiol.
2001;
37
1430-1435
- 20
Schroeder S, Kuettner A, Kopp A F et al..
Noninvasive evaluation of the prevalence of noncalcified atherosclerotic plaques by
multi-slice detector computed tomography: results of a pilot study.
Int J Cardiol.
2003;
92
151-155
- 21
Schroeder S, Kuettner A, Wojak T et al..
Non-invasive evaluation of atherosclerosis with contrast enhanced 16 slice spiral
computed tomography: results of ex vivo investigations.
Heart.
2004;
90
1471-1475
- 22
Schroeder S, Kuettner A, Leitritz M et al..
Reliability of differentiating human coronary plaque morphology using contrast-enhanced
multislice spiral computed tomography: a comparison with histology.
J Comput Assist Tomogr.
2004;
28
449-454
- 23
Virmani R, Burke A P, Farb A et al..
Pathology of the vulnerable plaque.
J Am Coll Cardiol.
2006;
47
C13-C18
- 24
Schroeder S, Kuettner A, Wojak T et al..
Non-invasive evaluation of atherosclerosis with contrast enhanced 16 slice spiral
computed tomography: results of ex vivo investigations.
Heart.
2004;
90
1471-1475
- 25
Leber A W, Knez A, Becker A et al..
Accuracy of multidetector spiral computed tomography in identifying and differentiating
the composition of coronary atherosclerotic plaques: a comparative study with intracoronary
ultrasound.
J Am Coll Cardiol.
2004;
43
1241-1247
- 26
Achenbach S, Moselewski F, Ropers D et al..
Detection of calcified and noncalcified coronary atherosclerotic plaque by contrast-enhanced,
submillimeter multidetector spiral computed tomography: a segment-based comparison
with intravascular ultrasound.
Circulation.
2004;
109
14-17
- 27
Leber A W, Becker A, Knez A et al..
Accuracy of 64-slice computed tomography to classify and quantify plaque volumes in
the proximal coronary system: a comparative study using intravascular ultrasound.
J Am Coll Cardiol.
2006;
47
672-677
- 28
Hausleiter J, Meyer T, Hadamitzky M et al..
Prevalence of noncalcified coronary plaques by 64-slice computed tomography in patients
with an intermediate risk for significant coronary artery disease.
J Am Coll Cardiol.
2006;
48
312-318
- 29
Budoff M J.
Prevalence of soft plaque detection with computed tomography.
J Am Coll Cardiol.
2006;
48
319-321
- 30
Gerber T C, Stratmann B P, Kuzo R S et al..
Effect of acquisition technique on radiation dose and image quality in multidetector
row computed tomography coronary angiography with submillimeter collimation.
Invest Radiol.
2005;
40
556-563
Prof. Dr. Stephen Schroeder
Department of Internal Medicine, Division of Cardiology, Eberhard Karls-University
Tübingen
Otfried-Mueller-Str. 10, 72076 Tübingen, Germany
Email: Stephen.Schroeder@med.uni-tuebingen.de