Histopathological correlates of the napkin-ring sign plaque in coronary CT angiography

被引:56
作者
Seifarth, Harald [1 ,2 ,3 ]
Schlett, Christopher L. [1 ,2 ]
Nakano, Masataka [4 ]
Otsuka, Fumiyuki [4 ]
Karolyi, Mihaly [1 ,2 ]
Liew, Gary [1 ,2 ]
Maurovich-Horvat, Pal [1 ,2 ]
Alkadhi, Hatem [1 ,2 ]
Virmani, Renu [4 ]
Hoffmann, Udo [1 ,2 ]
机构
[1] Massachusetts Gen Hosp, Cardiac MR PET CT Program, Boston, MA 02114 USA
[2] Harvard Univ, Sch Med, Boston, MA 02114 USA
[3] Univ Munster, Dept Clin Radiol, Munster, Germany
[4] CV Path Inst Inc, Gaithersburg, MD USA
关键词
Coronary CT angiography; Vulnerable plaque; Atherosclerosis; Angiogenesis; Calcification; ATHEROSCLEROTIC PLAQUE; NONINVASIVE ASSESSMENT; VASCULAR-LESIONS; CULPRIT; ARTERIOSCLEROSIS; CLASSIFICATION; DEFINITION; COMMITTEE; COUNCIL;
D O I
10.1016/j.atherosclerosis.2012.06.021
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: The purpose of this study was to identify histologic characteristics of advanced coronary atherosclerotic plaques that are related with the detection of the napkin-ring sign (NRS) in coronary CT angiography (CCTA). Methods: CCTA was performed in 7 human donor hearts. Histological slicing and stainings were performed in 1 mm increments of each major coronary artery. Histology was co-registered with the CT-data and classified according to the modified AHA classification. Results: Advanced plaques (types IV-VI) were present in 139 (23%) of 611 cross sections. Of these 33 (24%) demonstrated an NRS in CCTA. NRS plaques were associated with greater non-core plaque area (median 10.2 vs. 6.4 mm(2), p < 0.01) and larger vessel area (median 17.1 vs. 13.0 mm(2), p < 0.01). The area of the necrotic/lipid core was larger in plaques with NRS (median 1.1 vs. 0.5 mm(2), p = 0.05). Angiogenesis tended to be more frequent in plaques with NRS (48% vs. 30%) whereas micro-calcifications tended to be more frequent in plaques without NRS (27% vs. 46%) (p = 0.06 and 0.07 respectively). In a multivariate analysis, necrotic/lipid core area (OR = 1.9), non-core plaque area (OR = 1.6), and total vessel area (OR = 0.9) independently predicted the appearance of the NRS in coronary CT angiography. Conclusion: Delineation of NRS in CCTA is independently linked to the size of the necrotic/lipid core, the size of the non-core plaque and to the vessel area as measured in histology of advanced coronary atherosclerotic plaques. (c) 2012 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:90 / 96
页数:7
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