Non-invasive assessment of plaque rupture by 64-slice multidetector computed tomography:comparison with intravascular ultrasound

Background Plaque rupture and secondary thrombus formation play key roles in the onset of acute coronary syndrome (ACS). Multidetector computed tomography (MDCT) allows the non-invasive assessment of coronary artery stenosis and plaque properties. In this study, we investigated whether 64-slice MDCT could non-invasively detect a plaque rupture in patients with de novo angina.Methods and Results The study population comprised 67 patients with de novo angina. All patients underwent contrast-enhanced 64-slice MDCT and intravascular ultrasound (IVUS). Patients were divided into a plaque rupture group (n=27) and a non-rupture group (n=40) based on the IVUS. The 64-slice MDCT revealed that the prevalence of an ulcer-like enhancement space (37% vs 5%, p<0.01), a ring-like sign (41% vs 18%, p=0.04), in the plaque rupture group was higher than those in the non-rupture group. Maximum plaque thickness (2.1 +/- 0.9mm vs 1.6 +/- 1.0mm, p=0.04), outer vessel area (17.6 +/- 4.9mm(2) VS 13.4 +/- 5.0mm(2), p<0.01), percentage plaque area (82.3 +/- 9.1% vs 73.4 +/- 15.7%, p=0.01), and remodeling index (1.11 +/- 0.18 vs 1.01 +/- 0.15, p=0.04) of the plaque rupture group were all significantly larger than those of the non-rupture group.Conclusions The 64-slice MDCT can identify differences in lesion morphologies between ruptured plaques and non-ruptured plaques. From our results, the 64-slice MDCT might provide a useful tool for the non-invasive detection of plaque rupture.