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• W2159888916 abstract "A 54-year-old man who had history of hypertension was admitted to our hospital complaining of exertional chest pain. He did not have episodes of Kawasaki disease. Electrocardiogram showed q waves in III and aVF. Echocardiogram revealed dilatation of the left ventricle (LVDd/s 74/56 mm) and akinesis in the inferior and posterolateral left ventricular segments. Exercise thallium-201 scintigram demonstrated a fixed defect in the inferior and posterolateral left ventricular segments, indicating infarction in the right coronary artery territory. Multidetector-row computed tomography (MDCT) was performed using a LightSpeed Ultra (GE Systems, USA) with the slice thickness of 1.25 mm; pitch of 0.3:1; gantry rotation time of 0.5 s; temporal resolution of 125 ms and the trigger point of 70–80% R-R. The 80 ml of contrast medium (Omnipaque 300; Daiichi Pharmaceutical Co., Ltd., Tokyo, Japan) was used. Curved multiplanar reformation (MPR) image showed coronary aneurysm in the left anterior descending artery (Fig 1). Cross-sectional images of the aneurysm were converted into Plaque Map [ 1 Komatsu S. Hirayama A. Omori Y. et al. Detection of Coronary Plaque by Computed Tomography with the Novel Plaque Analysis System “Plaque Map” and Comparison with Intravascular Ultrasound and Angioscopy. Circ J. 2005; 69: 72-77 Crossref PubMed Scopus (88) Google Scholar , 2 Komatsu S. Omori Y. Murakawa T. et al. Detection of Plaque of Saphenous Vein Graft by Multislice Computed Tomography and Comparison with Gray-scale/Virtual Histology Intravascular Ultrasound. Int J Cardiol. 2005; ([Electronic publication, December 22]) Google Scholar ] which disclosed an eccentric CT-low-dense layer suggesting an atherosclerotic plaque (Fig. 1B). Egg-shell like calcification typical to Kawasaki disease [ [3] Kanamaru H. Sato Y. Takayama T. et al. Assessment of coronary artery abnormalities by multislice spiral computed tomography in adolescents and young adults with Kawasaki disease. Am J Cardiol. 2005; 95: 522-525 Abstract Full Text Full Text PDF PubMed Scopus (57) Google Scholar ] was not observed. Left coronary angiogram showed a spindle-shaped aneurysm in the left anterior descending artery and occlusion in the left circumflex artery (Fig. 1C) and right coronary angiogram disclosed high-grade stenosis (Fig. 1D). For further analysis of the aneurysm texture, intravascular ultrasound (IVUS) and coronary angioscopy were performed. IVUS revealed an eccentric, hypoechoic layer (Fig. 2A ) and coronary angioscopy demonstrated a grade 3 [ [4] Ueda Y. Asakura M. Yamaguchi O. et al. The healing process of infarct-related plaques. Insights from 18 months of serial angioscopic follow-up. J Am Coll Cardiol. 2001; 38: 1916-1922 Abstract Full Text Full Text PDF PubMed Scopus (111) Google Scholar ] yellow plaque (Fig. 2B), findings consistent with a lipid-rich atherosclerotic plaque. The patient underwent stent implantation in the right coronary artery. Anticoagulation therapy with warfarin was started for preventing further thrombus formation within the aneurysm. Fig. 2(A) Intravascular ultrasound images in the proximal (left) and middle (right) portions of the aneurysm showing an eccentric hypoechoic layer (arrows). (B) Coronary angioscopic images showing a grade 3 yellow plaque (arrows). View Large Image Figure Viewer Download Hi-res image" @default.
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• W2159888916 date "2007-05-01" @default.
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• W2159888916 title "MDCT detection of an atherosclerotic coronary artery aneurysm: Evaluation by Plaque Map" @default.
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• W2159888916 doi "https://doi.org/10.1016/j.ijcard.2006.05.078" @default.
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