Noninvasive Detection of Coronary Atherosclerotic Plaques and Assessment of Stenosis Degree at Multidetector CT Coronary Angiography

64 - slice MDCT has shown a sensitivity of 86 similar to 99% and a specificity of 79 similar to 96% in detecting lesions >50% stenosis. Spatial resolution of current MDCT technology enables reliable detection of nonobstructing noncalcific plaques as well as significantly stenotic lesions. CT densitometry on the plaques may give an insight on vulnerability of the lesions defined as less than 30 similar to 50 HU. MDCT coronary angiography has a tendency of overestimation of stenosis degree especially in distal segments of left anterior descending and circumflex arteries and their branches and in heavily calcified lesions as compared with quantitative catheter coronary angiography. Semi-automatic vessel segmentation techniques for coronary CT angiography may help assess the stenosis degree quantitatively. Recently developed dual-source 128-slice CT has shown diagnostic quality images in patients with high heart rates. Along with forth-coming 256-slice CT, new CT technologies are expected to enable highly reliable detection of coronary artery plaques and accurate estimation of stenosis degree.