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Komatsu S, 2011

Pathology of Vulnerable Plaque

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Naghavi M; 2003

Criteria Vulnerable Plaque

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Vulnerable plaque detectionin vivo

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Intra-Coronary Imaging Techniques to Detect Vulnerable Plaque

Salvatore Brugaletta1-2, Hector M. Garcia-Garcia1, and Patrick W. Serruys1, 1Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands, 2Thorax

Institute, Department of Cardiology, University Hospital Clinic, Barcelona, Spainhttp://www.athero.org/commentaries/comm1081.asp

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Vulnerable plaque detection

in vivo

NON INVASIVE ?

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9Knuuti J; 2012

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10Feyter PJ; 2007

Two modes :

The non-contrast enhanced MDCT : calcium scoring

The contrast enhanced MDCT : non-calcified and

calcified plaque

DCT

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11

  DCT

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MDCT Characteristics of Vulnerable Plaque

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13

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MDCT Characteristics of Vulnerable Plaque

13 Januari 2011

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Cases

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Case 1.

Smoker, Dyslipidemia, Stress. Chest discomfort

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Anterior MI June 201311Feb 2013

Case 2.

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Case .

ACS. Risk factors: Smoker, Dyslipidemia.

LM

LAD

LCX

D1

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LM

LAD

LCX

D1

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Implication for

Patient Management

Stabilisation

Regression

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Early detection? 

Prevention of future events? 

Evaluation of treatment? 

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Kevin M. Johnson, David A. Dowe, Tara M. Catanzano and James A. Brink

American Journal of Roentgenology. 2006;187: W241-W241.

Atorvastatin 40mg/d

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26 Journal of Cardiology Cases 2012 5, e92-e95DOI: (10.1016/j.jccase.2012.01.001)

Pitavastatin (2mg/day)

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Strengths and Weaknesses

Schroeder S, 2008

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SUMMARY

Low attenuated plaque, positive remodeling and spotty calcifi-

cation are revealed associated with the presence of vulnerable

plaque determined by MDCT 64-slice

MDCT would be the method of choice in identifying vulnerable

plaques non invasively in the near future

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