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Multidetector-row computed tomography of the coronary arteries: predictive value and quantitative assessment of non-calcified vessel-wall changes

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Abstract

The aim of this study was to quantitatively assess non-calcified coronary artery plaques and to determine their predictive value for the detection of coronary artery disease (CAD). A total of 179 patients underwent a calcium screening examination and a contrast-enhanced multidetector-row computed tomography angiography (MDCT) of the coronary arteries for various indications. The traditional calcium scores were evaluated and all examinations were reviewed for the presence of non-calcified plaques with an attenuation of 0–130 Hounsfield units (HU). The number, mean attenuation, and volume of these non-calcified plaques were recorded. All patients also underwent conventional catheter angiography. Coronary calcium was detected in 73% (131 of 179) of the patients. Overall incidence of purely non-calcified plaques was 30% (53 of 179). In 27% of the patients (48 of 179) no calcium was detected; however, 15% of these patients without calcifications showed non-calcified plaques (7 of 48). Significant correlations were found between the volume of calcified plaques, volume of non-calcified plaques, and total plaque volume. There were significant differences in plaque composition comparing different risk factor profiles and different stages of CAD. Volumetric assessment of non-calcified coronary artery plaques is feasible using contrast-enhanced MDCT. Screening for non-calcified plaques identifies patients with signs of CAD that are missed in a calcium screening examination.

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Authors and Affiliations

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

    Konstantin Nikolaou, Sonja Sagmeister, Bernd J. Wintersperger, Christoph R. Becker & Maximilian F. Reiser

  2. Department of Internal Medicine I, University of Munich Grosshadern, Marchioninistrasse 15, 81377, Munich, Germany

    Andreas Knez

  3. Siemens Medical Solutions, Forchheim, Germany

    Ernst Klotz

Authors
  1. Konstantin Nikolaou
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  2. Sonja Sagmeister
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  3. Andreas Knez
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  4. Ernst Klotz
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  5. Bernd J. Wintersperger
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  6. Christoph R. Becker
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  7. Maximilian F. Reiser
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Correspondence to Konstantin Nikolaou.

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Nikolaou, K., Sagmeister, S., Knez, A. et al. Multidetector-row computed tomography of the coronary arteries: predictive value and quantitative assessment of non-calcified vessel-wall changes. Eur Radiol 13, 2505–2512 (2003). https://doi.org/10.1007/s00330-003-2053-y

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  • DOI: https://doi.org/10.1007/s00330-003-2053-y

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