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Ex vivo coronary atherosclerotic plaque characterization with multi-detector-row CT

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Abstract

Multi-detector-row CT angiography (CTA) is a new technology that allows for non-invasive investigation of coronary atherosclerosis in patients. The relation between the morphology of atherosclerotic plaques assessed by CTA and histopathology is unknown. We investigated 11 human cadaver heart specimens. A mixture of methylcellulose and CT contrast media was injected into the coronary arteries to achieve in-vivo-like contrast enhancement within the coronary artery lumen. The morphologic pattern of atherosclerotic lesions found on CTA images and the tissue attenuation of non-calcified plaques were determined. After CTA imaging, atherosclerotic lesions in the coronary arteries were macroscopically identified and characterized histopathologically according to American Heart Association criteria. A total of 50 and 40 lesions were found macroscopically and by CTA, respectively. Thirty-three lesions could have been compared directly. The sensitivity of CTA compared with macroscopic detection of atheromas, fibroatheromas, fibrocalcified, and calcified lesions was 73, 70, 86, and 100%, respectively. The mean CT attenuation of predominantly lipid-rich and fibrous-rich plaques was significantly different (47±9 and 104±28 HU, respectively; p<0.01). Atherosclerotic coronary plaques detected by CTA may represent different stages of coronary atherosclerosis. The tissue attenuation of non-calcified plaques may allow for assessment of their predominant component.

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Authors and Affiliations

  1. Department of Clinical Radiology, University of Munich, Grosshadern, Marchioninistrasse 15, 81377, Munich, Germany

    Christoph R. Becker, Konstantin Nikolaou & Maximilian F. Reiser

  2. Department of Pathology, University Hospital Munich, Grosshadern, Marchioninistrasse 15, 81377 , Munich, Germany

    Michael Muders, Gregor Babaryka & Udo Loehrs

  3. Department of Medical Data Processing, Biometry and Epidemiology, University Hospital Munich, Grosshadern, Marchioninistrasse 15, 81377 , Munich, Germany

    Alexander Crispin

  4. Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA

    U. Joseph Schoepf

Authors
  1. Christoph R. Becker
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  2. Konstantin Nikolaou
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  3. Michael Muders
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  4. Gregor Babaryka
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  5. Alexander Crispin
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  6. U. Joseph Schoepf
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  7. Udo Loehrs
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  8. Maximilian F. Reiser
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Correspondence to Christoph R. Becker.

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Becker, C.R., Nikolaou, K., Muders, M. et al. Ex vivo coronary atherosclerotic plaque characterization with multi-detector-row CT. Eur Radiol 13, 2094–2098 (2003). https://doi.org/10.1007/s00330-003-1889-5

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  • DOI: https://doi.org/10.1007/s00330-003-1889-5

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