Abstract
Acute coronary syndrome (ACS) is caused by the disruption of vulnerable plaque and subsequent thrombosis. Coronary angioscopy is thought to be an effective modality for detecting not only the ruptured plaque but also the vulnerable plaques and patients. Previously, we reported that the extent of yellow-plaque formation evaluated by angioscopy reflects the risk of secondary coronary event in ACS patients. On the other hand, multi-detector row computed tomography (MDCT) can detect not only the coronary stenosis but also the outward remodeling and calcified spot in coronary arteries. Recently, some reports indicated that MDCT was useful for the non-invasive characterization of coronary plaques. MDCT can classify coronary plaques into soft, intermediate and calcified plaques by the CT number. We developed a new plaque-detecting system Plaque Map, which analyzes short-axis coronary CT images, and reported good correlation between yellow plaques (detected by angioscopy) and soft plaques (detected by Plaque Map) in patients with ACS. Quantitative and qualitative analysis of coronary plaques by Plaque Map might potentially be useful for the evaluation of plaque progression or regression. Analysis of MDCT would be improved by the validation of the analyzed results with angioscopy.
Keywords: Vulnerable plaque, vulnerable patient, angiography, multi-detector row computed tomography, acute coronary syndrome, plaque map, in silico, imaging