December 23, 2003Circulation
Detection of Calcified and Noncalcified Coronary Atherosclerotic Plaque by Contrast-Enhanced, Submillimeter Multidetector Spiral Computed Tomography
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Discussion
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Implication
Diagnostic study reveals multidetector computed tomography detects coronary plaque in nonstenotic arteries, highlighting potential utility despite underestimating lesion volume.
Key Points
- To evaluate the diagnostic accuracy and volumetric performance of submillimeter multidetector spiral computed tomography for detecting atherosclerotic plaque in nonstenotic coronary arteries compared with intravascular ultrasound.
- Assessed 22 patients without significant coronary stenoses who underwent contrast-enhanced multidetector computed tomography (0.75-mm collimation, 420-ms rotation) and intravascular ultrasound.
- Imaged and evaluated 83 coronary artery segments blindly across the left main, left anterior descending, left circumflex, and right coronary arteries to quantify calcified and noncalcified plaque presence and volume.
- Multidetector computed tomography detected coronary segments with any plaque with 82% sensitivity (41/50) and 88% specificity (29/33), and calcified plaque with 94% sensitivity (33/36) and 94% specificity (45/47).
- Noncalcified plaque was identified with 78% sensitivity (35/45) and 87% specificity (33/38), though sensitivity dropped to 53% (8/15) for isolated noncalcified plaque, improving to 91% sensitivity and 89% specificity in proximal segments.
- Computed tomography significantly underestimated plaque volume per segment compared with intravascular ultrasound (24±35 mm³ vs 43±60 mm³, P < 0.001).
Cite This Study
Achenbach et al. (2003) studied this question.