Non-invasive Diagnostic Methods for Atherosclerosis and Use in Assessing Progression and Regression in Hypercholesterolemia

The non-invasive quantitative determination of atherosclerosis is required in the treatment of risk factors. We evaluated the wall thickening and stenosis rate (ASI), the calcification rate (ACI) and the wall thickening and calcification stenosis rate (SCI) of the lower abdominal aorta calculated by the 12 sector method from simple or enhanced computed tomography.The intra-observer variation of the calculation of ASI was 5.7% and that of ACI was 2.4%. In 9 patients who underwent an autopsy examination, ACI was significantly correlated with the rate of the calcification dimension to the whole objective area of the abdominal aorta (r=0.856, p<0.01). However, there were no correlations between ASI and the surface involvement or the atherosclerotic index obtained by the point-counting method of the autopsy materials. In the analysis of 40 patients with atherosclerotic vascular diseases, ASI and ACI were also highly correlated with the percentage volume of the arterial wall in relation to the whole volume of the observed artery (r=0.852, p<0.0001) and also the percentage calcification volume (r=0.913, p<0.0001) calculated by the computed method, respectively.The percentage of atherosclerotic vascular diseases increased in the group of both high ASI (over 10%) and high ACI (over 20%). We used SCI as a reliable index when the progression and regression of atherosclerosis was considered. Among patients of hypercholesterolemia consisting of 15 with familial hypercholesterolemia (FH) and 6 non-FH patients, the change of SCI (d-SCI) was significantly correlated with the change of total cholesterol concentration (d-TC) after the treatment (r=0.466, p<0.05) and the change of the right Achilles' tendon thickening (d-ATT) was also correlated with d-TC (r=0.634, p<0.005). However, no correlation between d-SCI and d-ATT was observed.In conclusion, CT indices of atherosclerosis were useful as a noninvasive quantitative diagnostic method and we were able to use them to assess the progression and regression of atherosclerosis.