Comprehensive plaque assessment by coronary CT angiography

Pál Maurovich-Horvat, Maros Ferencik, Szilard Voros, Béla Merkely, Udo Hoffmann

    Research output: Contribution to journalReview article

    141 Scopus citations


    Most acute coronary syndromes are caused by sudden luminal thrombosis due to atherosclerotic plaque rupture or erosion. Preventing such an event seems to be the only effective strategy to reduce mortality and morbidity of coronary heart disease. Coronary lesions prone to rupture have a distinct morphology compared with stable plaques, and provide a unique opportunity for noninvasive imaging to identify vulnerable plaques before they lead to clinical events. The submillimeter spatial resolution and excellent image quality of modern computed tomography (CT) scanners allow coronary atherosclerotic lesions to be detected, characterized, and quantified. Large plaque volume, low CT attenuation, napkin-ring sign, positive remodelling, and spotty calcification are all associated with a high risk of acute cardiovascular events in patients. Computation fluid dynamics allow the calculation of lesion-specific endothelial shear stress and fractional flow reserve, which add functional information to plaque assessment using CT. The combination of morphologic and functional characteristics of coronary plaques might enable noninvasive detection of vulnerable plaques in the future.

    Original languageEnglish (US)
    Pages (from-to)390-402
    Number of pages13
    JournalNature Reviews Cardiology
    Issue number7
    StatePublished - Jul 2014

    ASJC Scopus subject areas

    • Cardiology and Cardiovascular Medicine

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