Abstract
Coronary CT angiography (CTA) is the first diagnostic modality that allows simultaneous evaluation of the lumen and wall of these small, rapidly pulsating arteries. Catheter coronary angiography, by contrast, only evaluates the internal, patent lumen of these vessels, without providing direct information on the vessel wall or the extent of vascular parietal involvement by atherosclerosis. While it identifies areas of stenosis or obstruction, it does not show details of the plaque itself, unless heavy calcifications make the atherosclerotic plaque evident on the X-ray image. Intravascular ultrasonography (IVUS) is an excellent method to obtain high-resolution images of the vascular wall, with identification of the different layers and proper characterization of the atherosclerotic plaque; however, it is an invasive procedure, performed in the course of catheter coronary angiography, and does not simultaneously evaluate the vessel lumen. Coronary CTA is therefore the first non-invasive imaging technique that allows evaluation of the lumen and walls of the coronary arteries, a particular advantage in determining the atherosclerotic burden in these arteries. Since atherosclerosis is a disease of the vessel wall, obtaining proper and direct evidence of a coronary plaque is an important new diagnostic possibility. The technique provides morphological information and CT density measurements, with important prognostic and therapeutic implications.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Budoff MJ, Shaw LJ, Liu ST et al (2007) Long-term prognosis associated with coronary calcification: observations from a registry of 25,253 patients. J Am Coll Cardiol 49:1860–1870
Ehara S, Kobayashi Y, Yoshiyama M et al (2004) Spotty calcification typifies the culprit plaque in patients with acute myocardial infarction. An intravascular ultrasound study. Circulation 110:3424–3429
Hendel RC, Patel MR, Kramer CM et al (2006) ACCF/ ACR/SCCT/SCMR/ASNC/NASCI/SCAI/S IR 2006 appropriateness criteria for cardiac computed tomography and cardiac magnetic resonance imaging. J Am Coll Cardiol 48:1475–97
Leber AW, Knez A, von Ziegler F et al (2005) Quantification of obstructive and nonobstructive coronary lesions by 64-slice computed tomography. A comparative study with quantitative coronary angiography and intravascular ultrasound. J Am Coll Cardiol 46:147–154
Redberg R (2006) Computed tomographic angiography. More than just a pretty picture? J Am Coll Cardiol 49:1827–1829
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2013 Springer-Verlag Italia
About this chapter
Cite this chapter
Pavone, P., Dowe, D.A., Leo, R. (2013). Identification and Characterization of the Atherosclerotic Plaque Using Coronary CT Angiography. In: Dowe, D.A., Fioranelli, M., Pavone, P. (eds) Imaging Coronary Arteries. Springer, Milano. https://doi.org/10.1007/978-88-470-2682-7_8
Download citation
DOI: https://doi.org/10.1007/978-88-470-2682-7_8
Publisher Name: Springer, Milano
Print ISBN: 978-88-470-2681-0
Online ISBN: 978-88-470-2682-7
eBook Packages: MedicineMedicine (R0)