 |
| Histology of the same vessel shows necrotic/lipid core. |
The advent of high-resolution cardiac CT scanning has revolutionized diagnostic and interventional cardiology. 64-Slice CT machines have now given way to 256- and even 320-slice CT scanners.
In patients with coronary artery disease, a key question is which plaques are most dangerous. That is, which are most likely to rupture and cause a clot in the lungs (pulmonary embolism), the brain (stroke), or lodge in the major coronary arteries and cause a heart attack. Now the way these arteriosclerotic lesions appear on cardiac CT gives us a clue.
The Napkin-Ring Sign
It turns out that blood vessels with plaques that resemble a napkin ring on CT are the most dangerous.
These plaques have a non-calcified, lipid-rich or necrotic core. How was this determined? If you guessed it was by correlating the radiographic appearance with photographs of actual cross-sections of the corresponding lesions themselves, give yourself a pat on the back. Good job!
Hopefully clinicians will now be able to zero in on plaques that show the telltale napkin-ring sign to identify the most dangerous plaques early and determine the best course of treatment.
 |
| The napkin-ring sign at 64-detector-row CT. |
Images courtesy of Dr. Harald Seifarth.
0 comments:
Post a Comment