Репозиторий Университета

© 2018 Russian Electronic Journal of Radiology. All rights reserved. Mainly, intracoronary thrombosis is the cause of acute coronary syndrome. The structure of the atherosclerotic plaque plays an important role in the development of the mechanism of intracoronary thrombosis. Currently, there are various radiological methods for diagnosis of atherosclerotic plaques of the coronary arteries. The current review reveals the theme of "indirect" signs of instability of atherosclerotic plaques, their combinations and occurrence, detected by computed tomography. Retrospective studies have shown the feasibility of these signs of plaques in the assessment of the prognosis of acute coronary events. The review compares the results of computed tomography (CT) and intravascular ultrasound, which is the gold standard in the diagnosis of atherosclerotic plaque morphology.

© 2018 Limited Liability Company KlinMed Consulting. All Rights Reserved. Until today, there are no universally accepted methods for detection of unstable atherosclerotic plaques, even though many recent studies were devoted to this issue. In this article we present modern possibilities of computed tomography in visualization of atherosclerotic coronary lesion, including the detection of unstable lesions, whot in turn, can help in diagnosing subclinical exacerbation of ischemic heart disease and in the stratification of risks of acute coronary events.

Problem of internal carotid artery disease diagnosis appears to be crucial today. Complications of this pathology are strokes and transient ischemic attacks. There is no technology for their prediction or at least stratifying risks. Some recent researches are devoted to a new diagnostic method. This new technology is called Contrast Enhanced Ultrasonography (CEUS) and followed by outstanding results in studying the morphological peculiarities of internal carotid artery plaques and predicting the probability of complications. CEUS is a new way for atherosclerotic process analysis because it is able to detect intraplaque neovascularization and vascular wall inflammation.

Previously, atherosclerosis was considered a disease accompanied exclusively by lipids accumulation. At present time success of fundamental and experimental science confirmed that atherosclerotic process is also associated with neovascularization and prolonged inflammatory response at all stages of atherogenesis from initial manifestations to thrombotic complications. The cause of atherosclerotic plaque instability is neovascularization, which is accompanied by intra-plaque hemorrhage and damage. Complications of carotid arteries atherosclerosis are strokes and transient ischemic attacks. The use of a wide range of diagnostic and pathohistological techniques is required for assessing this pathology. The most promising diagnostic technique is Contrast Enhanced Ultrasonography (CEUS) which allows to assess neovascularization degree in atherosclerotic plaque through the injection of a contrast agents.

© 2018 Russian Electronic Journal of Radiology.All right reserved. Purpose: Assessing the dynamics of vulnerability of atherosclerotic plaques in patients with angina pectoris on atorvastatin therapy (40 mg for 10-12 months) based on coronary computed tomography angiography (CCTA) data. Materials and methods: The study prospectively enrolled 74 patients with angina pectoris not medicated with statins. All patients underwent CCTA. 30 patients with vulnerability of atherosclerotic plaques were selected for further observation and atorvastatin was administered to them at dose of 40 mg. Repeated tomography scans were recorded 10-12 months later. Images were analyzed by "Vitrea" workstation in a blind manner. Statistical processing was performed on SPSS version 11.5 software (BioStat). Results: Statistically insignificant decrease in: total plaque volume (from 188.64 ± 35.8 to 184.96 ± 34.45 mm3), low-attenuation plaque (from 60.46 ± 12.87 to 57.06 ± 12.34 mm3), degree of stenosis (from 41.6 ± 3.16 to 40.65 ± 3.26%), spotty calcification (from 86.0 to 90%), remodeling index (from 1.25 [1,0;1,4] to 1.1 [1,0;1,4]), napkin-ring sign (from 69.76 to 60%), irregularity of the contour (from 79.1 to 65%). LDL levels decreased from 3.23 ± 0.33 to 2.76 ± 0.27 mmol/L. Statistically significant decrease of total cholesterol was from 5.75 ± 0.45 to 4.42 ± 0.57 mmol/L. The study also revealed statistically significant positive correlation between decrease of LDL levels and total plaque volume decrease (R=0.51, P=0.002), mainly because of lowattenuation components. Conclusion: We review our experience of using CCTA for noninvasive monitoring of vulnerability of atherosclerotic plaques in dynamics and show that atherosclerotic plaques stabilize on long-term atorvastatin treatment.