Ex vivo coronary atherosclerotic plaque characterization with multi-detector-row CT

Eur Radiol. 2003 Sep;13(9):2094-8. doi: 10.1007/s00330-003-1889-5. Epub 2003 Apr 12.


Multi-detector-row CT angiography (CTA) is a new technology that allows for non-invasive investigation of coronary atherosclerosis in patients. The relation between the morphology of atherosclerotic plaques assessed by CTA and histopathology is unknown. We investigated 11 human cadaver heart specimens. A mixture of methylcellulose and CT contrast media was injected into the coronary arteries to achieve in-vivo-like contrast enhancement within the coronary artery lumen. The morphologic pattern of atherosclerotic lesions found on CTA images and the tissue attenuation of non-calcified plaques were determined. After CTA imaging, atherosclerotic lesions in the coronary arteries were macroscopically identified and characterized histopathologically according to American Heart Association criteria. A total of 50 and 40 lesions were found macroscopically and by CTA, respectively. Thirty-three lesions could have been compared directly. The sensitivity of CTA compared with macroscopic detection of atheromas, fibroatheromas, fibrocalcified, and calcified lesions was 73, 70, 86, and 100%, respectively. The mean CT attenuation of predominantly lipid-rich and fibrous-rich plaques was significantly different (47+/-9 and 104+/-28 HU, respectively; p<0.01). Atherosclerotic coronary plaques detected by CTA may represent different stages of coronary atherosclerosis. The tissue attenuation of non-calcified plaques may allow for assessment of their predominant component.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Calcinosis / diagnostic imaging
  • Calcinosis / pathology
  • Coronary Angiography / methods
  • Coronary Artery Disease / diagnostic imaging*
  • Coronary Artery Disease / pathology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Tomography, X-Ray Computed / methods*