Consistency in Geometry Among Coronary Atherosclerotic Plaques Extracted From Computed Tomography Angiography

Abstract

Background: The three-dimensional (3D) geometry of coronary atherosclerotic plaques is associated with plaque growth and the occurrence of coronary artery disease. However, there is a lack of studies on the 3D geometric properties of coronary plaques. We aim to investigate if coronary plaques of different sizes are consistent in geometric properties.Methods: Nineteen cases with symptomatic stenosis caused by atherosclerotic plaques in the left coronary artery were included. Based on attenuation values on computed tomography angiography images, coronary atherosclerotic plaques and calcifications were identified, 3D reconstructed, and manually revised. Multidimensional geometric parameters were measured on the 3D models of plaques and calcifications. Linear and non-linear (i.e., power function) fittings were used to investigate the relationship between multidimensional geometric parameters (length, surface area, volume, etc.). Pearson correlation coefficient (r), R-squared, and p-values were used to evaluate the significance of the relationship. The analysis was performed based on cases and plaques, respectively. Significant linear relationship was defined as R-squared > 0.25 and p < 0.05.Results: In total, 49 atherosclerotic plaques and 56 calcifications were extracted. In the case-based analysis, significant linear relationships were found between number of plaques and number of calcifications (r = 0.650, p = 0.003) as well as total volume of plaques (r = 0.538, p = 0.018), between number of calcifications and total volume of plaques (r = 0.703, p = 0.001) as well as total volume of calcification (r = 0.646, p = 0.003), and between the total volumes of plaques and calcifications (r = 0.872, p < 0.001). In plaque-based analysis, the power function showed higher R-squared values than the linear function in fitting the relationships of multidimensional geometric parameters. Two presumptions of plaque geometry in different growth stages were proposed with simplified geometric models developed. In the proposed models, the exponents in the power functions of geometric parameters were in accordance with the fitted values.Conclusion: In patients with coronary artery disease, coronary plaques and calcifications are positively related in number and volume. Different coronary plaques are consistent in the relationship between geometry parameters in different dimensions.

Geometric features of middle cerebral artery are associated with spontaneous basal ganglia intracerebral haemorrhage

“…Studies have confirmed that the geometry of intracranial artery is an important factor in the development of atherosclerotic plaque 10–12. The arterial geometry, by haemodynamically working on the endothelia, can influence the growth of atherosclerotic plaques through the haemodynamic effect, leading to a consistency in geometry among different plaques 13. Moreover, the geometric properties of plaque can directly influence the risk of plaque rupture 14 15.…”

“…[10][11][12] The arterial geometry, by haemodynamically working on the endothelia, can influence the growth of atherosclerotic plaques through the haemodynamic effect, leading to a consistency in geometry among different plaques. 13 Moreover, the geometric properties of plaque can directly influence the risk of plaque rupture. 14 15 In fact, the plaque features, including geometry, are found to be associated with the acute symptoms in MCA.…”

Distinctive Morphological Patterns of Complicated Coronary Plaques in Acute Coronary Syndromes: Insights from an Optical Coherence Tomography Study

“…Different techniques currently exist for plaque characterization, ranging from non-invasive modalities, such as coronary computer tomography (CT), to intravascular imaging (intravascular ultrasound (IVUS) or optical coherence tomography (OCT)). Advances in coronary CT now allow for plaque geometrical and compositional assumptions [ 5 , 6 ] and it was proven that some of the features identified on CT imaging could correlate with the risk of future clinical events [ 7 ]. Nevertheless, CT interpretation is sometimes cumbersome due to certain factors, such as “the blooming’’ effect and low image resolution.…”

Incidental Vascular Findings in Computed Tomography Performed in the Qualification for the TAVI Procedure

“…It should be noted that one of the challenges in the assessment of calcification in computed tomography is the problem of blooming artifacts, due to which the accuracy of the assessment may be lower. De-blooming algorithms or manual extraction are potential solutions to increase the accuracy of refining the boundaries of calcifications [ 4 , 5 ].…”