Background. The purpose of the study was to systematically compare calcification patterns in plaques on computed tomography angiography (CTA) with plaque characteristics on intravascular ultrasound with radiofrequency backscatter analysis (IVUS-VH). Methods and Results. In total, 108 patients underwent CTA and IVUS-VH. On CTA, calcification patterns in plaques were classified as non-calcified, spotty or dense calcifications. Plaques with spotty calcifications were differentiated into small spotty (<1 mm), intermediate spotty (1-3 mm) and large spotty calcifications (≥3 mm). Plaque characteristics deemed more high-risk on IVUS-VH were defined by % necrotic core (NC) and presence of thin cap fibroatheroma (TCFA). Overall, 300 plaques were identified both on CTA and IVUS-VH. % NC core was significantly higher in plaques with small spotty calcifications as compared to noncalcified plaques (20% vs 13%, P = .006). In addition, there was a trend for a higher % NC in plaques with small spotty calcifications than in plaques with intermediate spotty calcifications (20% vs 14%, P = .053). Plaques with small spotty calcifications had the highest % TCFA as compared to large spotty and dense calcifications (31% vs 9% and 31% vs 6%, P < .05). Conclusion. Plaques with small spotty calcifications on CTA were related to plaque characteristics deemed more high-risk on IVUS-VH. Therefore, CTA may be valuable in the assessment of the vulnerable plaque. (J Nucl Cardiol 2011;18:893-903.)

Additional Metadata
Keywords Atherosclerosis, Computed tomography (CT), Vulnerable atherosclerotic plaque
Persistent URL dx.doi.org/10.1007/s12350-011-9428-2, hdl.handle.net/1765/62467
Journal Journal of Nuclear Cardiology
Citation
van Velzen, J.E, de Graaf, F.R, de Graaf, M.A, Schuijf, J.D, Kroft, L.J.M, de Roos, A, … van der Wall, E.E. (2011). Comprehensive assessment of spotty calcifications on computed tomography angiography: Comparison to plaque characteristics on intravascular ultrasound with radiofrequency backscatter analysis. Journal of Nuclear Cardiology, 18(5), 893–903. doi:10.1007/s12350-011-9428-2