Copyright
©The Author(s) 2016.
World J Cardiol. Sep 26, 2016; 8(9): 520-533
Published online Sep 26, 2016. doi: 10.4330/wjc.v8.i9.520
Published online Sep 26, 2016. doi: 10.4330/wjc.v8.i9.520
Culprit lesion | Coronary lesion considered to be responsible for the clinical event, usually plaque complicated by intraluminal thrombosis |
Thrombosed plaque | Plaque with an overlying thrombus extending into the vessel lumen either occlusive or non-occlusive |
Eroded plaque | Thrombosed plaque (mainly fibrotic or proteoglycan-rich) due to loss or dysfunction of endothelial cells without associated rupture |
Plaque with calcified nodule | Heavily calcified protruding plaque with loss or dysfunction of endothelial cells |
Vulnerable, high-risk or thrombosis prone plaque | Plaque at increased risk of thrombosis and rapid stenosis progression TCFA: Inflamed plaque with a thin cap covering a lipid-rich necrotic core |
Vulnerable patient | Patient at high-risk to experience a cardiovascular ischemic event due to a high atherosclerotic burden, high-risk plaques and/or thrombogenic blood |
CCT | CMR | PET | |
Plaque characterization | Plaque morphology | Plaque morphology Tissue characterization of plaque | Inflammation (FDG) Macrophage infiltration (new tracers) |
Vulnerable features | Positive remodeling Low attenuation Spotty calcification Napkin-ring sign | Positive remodeling T1 hyperintensity Late gadolinium enhancement | Increased tracer uptake |
Clinical relevance | Strong association with ACS Prediction of slow-flow after PCI Evaluation of response to statins | Initial data of association of T1 hyperintense plaques with slow-flow, ACS and response to statins | Differentiation between ACS and stable coronary disease |
Limitations | Radiation exposure Heavy calcification Overlap in attenuation ranges Inability to detect plaque erosion | Direct relation between spatial resolution and acquisition time Susceptibility to motion artifacts | Low spatial and temporal resolution Myocardial background uptake Expensive and limited availability |
- Citation: Pozo E, Agudo-Quilez P, Rojas-González A, Alvarado T, Olivera MJ, Jiménez-Borreguero LJ, Alfonso F. Noninvasive diagnosis of vulnerable coronary plaque. World J Cardiol 2016; 8(9): 520-533
- URL: https://www.wjgnet.com/1949-8462/full/v8/i9/520.htm
- DOI: https://dx.doi.org/10.4330/wjc.v8.i9.520