J Korean Med Sci.  2011 Aug;26(8):1052-1060. 10.3346/jkms.2011.26.8.1052.

Relationship between Coronary Artery Calcium Score by Multidetector Computed Tomography and Plaque Components by Virtual Histology Intravascular Ultrasound

• Choi YH
• Hong YJ
• Park IH
• Jeong MH
• Ahmed K
• Hwang SH
• Lee MG
• Park KH
• Sim DS
• Kim JH
• Ahn Y
• Cho JG
• Park JC
• Kang JC

• KMID: 1777844
• DOI: http://doi.org/10.3346/jkms.2011.26.8.1052

Abstract

The aim of this study was to evaluate the relationship between coronary artery calcium score (CACS) assessed by multidetector computed tomography (MDCT) and plaque components assessed by virtual histology-intravascular ultrasound (VH-IVUS) in 172 coronary artery disease (CAD) patients with 250 coronary lesions. CACS was assessed according to Agatston scoring method by MDCT and patients were divided into four groups: Group I (CACS = 0 [n = 52]); Group II (CACS = 1-100 [n = 99]); Group III (CACS = 101-400 [n = 84]); and Group IV (CACS > 400 [n = 15]). Total atheroma volume was greatest in Group IV (152 +/- 132 microL vs 171 +/- 114 microL vs 195 +/- 149 microL vs 321+/-182 microL, P < 0.001). The absolute dense calcium (DC) and necrotic core (NC) volumes were greatest, and relative DC volume was greatest in Group IV (5.5 +/- 6.6 microL vs 11.0 +/- 10.3 microL vs 15.6 +/- 13.6 microL vs 36.6 +/- 18.2 microL, P < 0.001, and 14.8 +/- 18.2 microL vs 19.5 +/- 18.9 microL vs 22.5 +/- 19.1 microL vs 41.7 +/- 27.9 microL, P < 0.001, and 6.4 +/- 5.3% vs 11.0 +/- 6.2% vs 14.0 +/- 6.5% vs 20.0 +/- 7.8%, P < 0.001, respectively). The absolute plaque and DC and NC volumes and the relative DC volume correlated positively with calcium score. CAD patients with high calcium score have more vulnerable plaque components (greater DC and NC-containing plaques) than those with low calcium score.

Keyword

Coronary Disease; Multidetector Computed Tomography; Coronary Artery Calcium Score; Plaque; Intravascular Ultrasound

MeSH Terms

Adult
Aged
Calcinosis/*diagnosis/radiography/ultrasonography
Calcium/*analysis
Coronary Angiography
Coronary Artery Disease/*diagnosis/radiography/ultrasonography
Coronary Vessels/pathology
Female
Humans
Male
Middle Aged
*Multidetector Computed Tomography
Necrosis
Plaque, Atherosclerotic/*pathology
*Ultrasonography, Interventional

Figure

• 

  Fig. 1 The examples of coronary artery calcium detected by cardiac multidetector computed tomography (MDCT) (A) and plaque components assessed by virtual histology-intravascular ultrasound (VH-IVUS) (B).

• 

  Fig. 2 Absolute (A) and relative (B) plaque components at the minimum lumen area sites. Absolute dense calcium and relative dense calcium (%) areas were greatest in Group IV; in contrast, relative fibrous (%) area was smallest in Group IV.

• 

  Fig. 3 Absolute (A) and relative (B) plaque components by volumetric analysis. Absolute and relative dense calcium (%) and necrotic core (%) volumes were greatest in Group IV; in contrast, relative fibrous (%) volume was smallest in Group IV.

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