ABSTRACT
Detection of vulnerable atherosclerotic plaques within the wall of the coronary arteries may be a key factor for the prevention of acute events.1,2 Several invasive and non-invasive imaging modalities have been applied to the visualization of coronary artery atherosclerotic plaques.1,2 Three major non-invasive techniques are able to directly display coronary arteries in different ways: electron-beam computed tomography (EBCT), magnetic resonance imaging (MRI), and
multislice (multidetector) computed tomography (MDCT). EBCT has served for several years for the detection and quantification of coronary calcium3 and recently to establish the presence of coronary obstructive lesions.4,5 MRI has been applied to the visualization of coronary arteries,6,7 and, with the introduction of 3 T magnets, now has improved reliability and image quality.8,9
Recently, a new generation of MDCT scanners has been introduced with new technical capabilities compared with the widely used spiral CT scanners.10 The improved spatial and temporal
resolution of MDCT allows non-invasive evaluation of the coronary arteries. The main field of application was initially the visualization of obstructive and non-obstructive coronary artery plaques.11,12 Initial comparisons of the results of MDCT coronary angiography with those of intravascular ultrasound (IVUS)13 found that absolute CT density measurements allowed further classification of non-calcified plaques as predominantly lipid or fibrous plaques. Similar results have been reported in more recently published studies using newer CT scanner systems.14-16 Currently, distinction between calcific, non-calcific, and mixed (containing both calcific and non-calcific plaque tissue) plaques seems to be feasible with MDCT.17
