Journal of Cardiovascular Computed Tomography
Volume 4, Issue 5 , Pages 301-308, September 2010

Ex vivo evaluation of coronary atherosclerotic plaques: Characterization with dual-source CT in comparison with histopathology

  • Sebastian Leschka, MD

      Affiliations

    • Institute of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland
    • Institute of Radiology, Kantonsspital St. Gallen, St. Gallen, Switzerland
    • Corresponding Author InformationCorresponding author.
    • ,
  • Sara Seitun, MD

      Affiliations

    • Institute of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland
    • Department of Vascular and Interventional Radiology, San Martino University Hospital, Genoa, Italy
    • ,
  • Matthias Dettmer, MD

      Affiliations

    • Institute of Clinical Pathology, University Hospital Zurich, Zurich, Switzerland
    • Institute of Pathology, Kantonsspital St. Gallen, St. Gallen, Switzerland
    • ,
  • Stephan Baumüller, MD

      Affiliations

    • Institute of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland
    • ,
  • Paul Stolzmann, MD

      Affiliations

    • Institute of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland
    • ,
  • Robert Goetti, MD

      Affiliations

    • Institute of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland
    • ,
  • Hans Scheffel, MD

      Affiliations

    • Institute of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland
    • ,
  • Gudrun Feuchtner, MD

      Affiliations

    • Institute of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland
    • ,
  • Kathrin Wunnicke, MD

      Affiliations

    • Institute of Radiology, Kantonsspital St. Gallen, St. Gallen, Switzerland
    • ,
  • Simon Wildermuth, MD

      Affiliations

    • Institute of Radiology, Kantonsspital St. Gallen, St. Gallen, Switzerland
    • ,
  • Christian Oehlschlegel, MD

      Affiliations

    • Institute of Pathology, Kantonsspital St. Gallen, St. Gallen, Switzerland
    • ,
  • Borut Marincek, MD

      Affiliations

    • Institute of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland
    • ,
  • Wolfram Jochum, MD

      Affiliations

    • Institute of Pathology, Kantonsspital St. Gallen, St. Gallen, Switzerland
    • ,
  • Hatem Alkadhi, MD

      Affiliations

    • Institute of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland

Received 2 October 2009; accepted 29 May 2010. published online 07 June 2010.

Background

Identification and differentiation of coronary atherosclerotic plaques may improve risk stratification for incident coronary events.

Objective

We investigated the ability of dual-source computed tomography (CT) to depict and characterize atherosclerotic coronary plaques.

Methods

Contrast-enhanced CT was performed in 25 human heart specimens with a total of 322 histologically determined plaques. Coronary plaques were classified on CT as (1) noncalcified, mixed, or calcified and (2) by CT attenuation values. Atherosclerotic plaques were histopathologically characterized according to the Stary classification.

Results

CT detected 79% (245/322) of all plaques. Lesions missed by CT were generally early lesions, type I (n = 31), type II (n = 38), or type III (n = 8), according to Stary. CT detected 29% of early (Stary I–III) and 100% of advanced (Stary IV–VIII) plaques. Plaque classification as noncalcified was sensitive (100%) and specific (72%) for early, whereas classification as mixed/calcified was sensitive (92%, 89%) and specific (100%) for advanced plaques. Calcified plaques on CT were detected with high sensitivity (80%) and specificity (95%). Other subtypes were not distinguishable with CT according to the presence or absence of calcification. CT density was significantly higher for advanced (306 ± 470 HU) than for early (42 ± 14 HU; P < 0.01) plaques. The mean CT density value of type VII plaques (512 ± 349 HU) was significantly higher than those of other plaques (34–101 HU; P < 0.001).

Conclusions

CT reliably depicts advanced coronary plaques and allows for the differentiation between early and advanced plaques.

Keywords: Atherosclerosis, Computed tomography, Coronary artery, Histology, Plaque

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 Conflict of interest: The authors report no conflicts of interest.

PII: S1934-5925(10)00354-0

doi:10.1016/j.jcct.2010.05.016

Journal of Cardiovascular Computed Tomography
Volume 4, Issue 5 , Pages 301-308, September 2010

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