Abstract
Purpose.To determine the possibilities of coronary CT-angiography (CTA) in evaluation of qualitative and qualitative parameters of coronary plaques in comparison with intravascular ultrasound (IVUS).Matherials and methods.37 patients (29 men, 8 women) with symptoms of acute coronary syndrome (ACS) were included in the study. Unstable angina was detected in 24 patients, acute myocardial infarction (AMI) – in 13 patients. Averageage was 58 [44; 65] years. CTA had been performed as the first method of beam diagnostics in all cases if it was not necessary to use the emergency selective coronary angiography (CAG). IVUS was performed in one, two or three coronary arteries of every patient. Total, 60 coronary lesionsin 55 arteries were examined with IVUS. IVUS data was compared with CTA data.Results.Methods well correlated in detection of plaque burden (r = 0.823; p < 0.0001), plaque length (r = 0.932, p < 0.0001), remodeling index(RI) (r = 0.906; p < 0.0001). Sensitivity and specificity of CTA in detection of irregular contour was 96.1% and 88.9% (area under ROC-curve 0.925), positive remodeling – 100% and 97.4% (area under ROC-curve 0.974). CTA and IVUS in evaluation of spotty calcinates was not coincide in 9 plaques, sensitivity and specificity of CTA in detection of 71% and 100% (area under ROC-curve 0.855).Discussion.Comparison of CTA and IVUS was performed in evaluation of plaques features in patients with ACS. This analysis showed high comparability of methods for evaluation of coronary stenosis degree, RI, plaque burden, length and contour. Thus, the characteristics of plaques according to CTA data can be used to stratify the risk of development of ACS.Conclusion.CTA – fast non-invasive method of coronary plaques evaluation. CTA correlates well with IVUS.
Highlights
Цель исследования: определить возможности компьютерная томография (КТ)-ангиографии (КТА) в оценке количественных и качественных характеристик атеросклеротических бляшек (АСБ) в коронарных артериях по сравнению с данными внутрисосудистого ультразвукового исследования (ВСУЗИ)
Unstable angina was detected in 24 patients, acute myocardial infarction (AMI) – in 13 patients
CTA had been performed as the first method of beam diagnostics in all cases if it was not necessary to use the emergency selective coronary angiography (CAG)
Summary
Цель исследования: определить возможности КТ-ангиографии (КТА) в оценке количественных и качественных характеристик атеросклеротических бляшек (АСБ) в коронарных артериях по сравнению с данными внутрисосудистого ультразвукового исследования (ВСУЗИ). Каждому из 37 пациентов ВСУЗИ было выполнено в одной, двух или трех коронарных артериях. Корреляционный анализ показал высокую сопоставимость методов в определении бремени бляшки (r = 0,823; p < 0,0001), протяженности бляшки (r = 0,932; p < 0,0001), индекса ремоделирования (ИР) (r = 0,906; p < 0,0001). При оценке точечных кальцинатов в 9 мягких бляшках данные КТА не совпадали с данными ВСУЗИ. В представленной работе впервые в нашей стране проведен сравнительный анализ состояния бляшек в коронарных артериях по данным КТА и ВСУЗИ у больных с ОКС, который показал высокую сопоставимость методов для определения степени стенозирования просвета коронарных артерий, ИР, бремени, протяженности и контуров бляшки. Результаты КТА хорошо коррелируют с данными ВСУЗИ
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