Quantitative Research Of Coronary Atherosclerotic Plaque Using Dual-source64-slice Spiral Computed Tomography

Objective The purpose of the study was to compare the plaque composition betweenpatients with acute coronary syndrome(ACS) and stable angina pectoris(SAP) by dual-source64-slice spiral computed tomography. Providing a quantitative basis for the effective detectionof vulnerable plaque.Methods One hundred patients who were evaluated by CCTA using64-slice dual-sourceCT were divided into ACS group (n=50,50responsibility plaque) and SAP group (n=50,50responsibility plaque). Analysis the differences of plaque burden, distribution and the relativeratio of any plaque component between two groups. Analysis the correlation between coronarystenosis and the burden, compositions of atherosclerotic plaque.Results There were no significant differences in Clinical data between ACS and SAPpatients. Responsibility plaques of ACS group are mainly distributed in the proximal coronarytree. No significant bias was observed in the distribution of responsibility plaque between twogroups. The plaque burden was larger in responsibility plaque of ACS than SAP(58.37%±15.24%vs.49.11%±13.38%p<0.01). Responsibility plaque of ACS showed higherpercentage of lipid (46.65%±11.95%vs.28.42%±11.19%p<0.01) and lower percentage ofcalcification (5.54%±1.69%vs.20.26%±4.36%p<0.01) as regard to SAP ones with statisticaldifference (p<0.05). Percentage of fibrous component revealed no significant difference(47.80%±10.73%vs.51.12%±15.62%p>0.05) between ACS and SAP patients.The sensitivity,specificity, PPV and NPV were84.00%,80.00%,80.77%and83.33%for DSCT to detectvulnerable plaques with fatty components of plaque (≥36.92%) as the cutoff value. At severe stenosis of the coronary artery, the lesions showed large plaque burden, higher fatty components,and lower levels of calcified components than those moderate stenosis of the coronary artery (p<0.05).Conclusion As a non-invasive technique of Coronary CT angiography has a good abilityto quantify the volume and plaque components of coronary atherosclerotic plaques. Vulnerableplaque has higher plaque burden and percentage of lipid compared with stable plaque,measuring the fatty components of plaque is important for the effective identification ofvulnerable plaque. Plaque which lead to severe stenosis of the coronary artery showed largeplaque burden and higher fatty components.