Noncalcified Atherosclerotic Plaque Burden at Coronary CT Angiography: A Better Predictor of Ischemia at Stress Myocardial Perfusion Imaging Than Calcium Score and Stenosis Severity

Abstract

At coronary CT angiography, noncalcified plaque burden is a better predictor of the finding of myocardial ischemia at stress myocardial perfusion imaging than are calcium score and degree of stenosis.

Systematic analysis on the relationship between luminal enhancement, convolution kernel, plaque density, and luminal diameter of coronary artery stenosis: a CT phantom study

“…Both coronary artery stenosis and plaque composition therein represent independent predictors of major adverse cardiac events (MACE) in patients with known and suspected CAD [3][4][5][6].…”

64-slice CT angiography for the detection of functionally significant coronary stenoses: comparison with stress myocardial perfusion imaging

“…In addition, spatial resolution of 64-slice CTA is still limited compared with that of ICA, which was demonstrated in our subset of patients undergoing ICA and might have influenced the precision of stenosis evaluation in these examinations and led to the discrepancies between the studies. Nonetheless, regardless of the accuracy of stenosis assessment, one should realise that, although high percentage narrowing ($70%) is a strong indicator of coronary resistance, other CTA characteristics, including lesion length, morphology and location as well as noncalcified plaque burden, are also important determinants [26,27]. Notably, in our patients with lesions of $70% stenosis on CTA, still approximately 1 of 4 (26%, 6/23) showed normal perfusion on SPECT MPI.…”

Serial Changes of Coronary Atherosclerotic Plaque: Assessment with 64-Slice Multi-Detector Computed Tomography

“…Lastly, the plaque was characterized by color coding based on CT value (HU). Referring to published studies (13)(14)(15), the software color codes of the non-calcified coronary plaque were classified into low attenuation plaque (0-50 HU), lipid-rich plaque, intermediate attenuation plaque (51-120 HU), fibrous plaque; and the volume of …”