관상동맥 협착부위에서의 석회화된 부위와 비 석회화된 부위의 에서의 64-slice MDCT와 IVUS 비교

Comparision of Calcified and Noncalcified coronary atherosclerotic plaque by 64-slice MDCT versus IVUS

Purpose Multi-detector row Computed Tomography (64-slice MDCT) permits noninvasive visualization of the coronary arteries. 64-slice MDCT is improving accuracy in coronary plaque detection and offers a better opportunity for plaque characterization, but its ability of exact separation of lumen, plaque, and vessel wall has not been evaluated. We evaluated the ability of 64-slice MDCT, compared with intravascular ultrasound(IVUS), to detect inner vessel wall calcified and noncalcified coronary atherosderotic plaque volume in patient with significant coronary artery stenosis. Materials and Methods In 50 patients, the contrast-enhanced 64-slice MDCT (120kv, 650mA, 0.35 sec rotation, 0.625mm helical thickness) and IVUS (40 MHz Coronary Imaging Catheter) were performed. Results In significant coronary stenosis ( > 50 % stenosis), 50 segments were obtained by IVUS and 64-slice MDCT. For calcified plaque, 64-slice MDCT overestimated Vessel Lumen Area per segment as compared with IVUS (2.135 mm² versus 2.515 mm²). For uncalcified plaque, 64-slice MDCT substantially underestimated Vessel Lumen Area per segment as compared with IVUS (3.725 mm² versus 3.333 mm²). Conclusion Our data suggests that 64-slice MDCT has the technical limitations to prevent an exact separation of lumen, plaque, and vessel wall. As a consequence, we observed a high variability for 64-slice CT measurements and an only moderate concordance to IVUS measurements. In calcified plaque, 64-slice MDCT Show a marked tendency to overesitmate plaque volume and weakly predictable to detect inner vessel wall calcified plaque. In uncalcified plaque, 64-slice MDCT is disposed to underestimate plaque volume as compared with IVUS.