Coronary calcification mimicking the stent: Analysis by MDCT Plaque Map

A 76-year-old man was admitted to our hospital complaining chest pain. His ECG showed ST elevation on II, III, aVF, V6. He was diagnosed as having acute inferior myocardial infarction; emergent coronary catheterization was performed. Coronary angiogram revealed an occlusion in the middle portion of the left circumflex artery without significant stenosis in other coronary arteries. Coronary intervention was accomplished by inserting two Driver stents (Medtronic Inc., MN, USA), 3.0×23 mm and 3.0×18 mm into the culprit lesions in the left circumflex artery (Fig. 1a). MDCT angiography was performed using a 16-slice scanner (LightSpeed 16, GE Systems, USA). 80 ml of the contrast medium (Iopamiron 370; Nihon Schering, Osaka, Japan) was injected at 3.5 ml/s. The slice thickness was 0.625 mm, pitch was 0.3:1, rotation time was 0.5 s., temporal resolution was 125 ms, and the trigger point was 70–80% (R-R). Curved multiplanar reformation image exhibited coronary stents in the left circumflex coronary artery (Fig. 1b) and calcification mimicking the stent in the left anterior descending artery (Fig. 1c). Cross-sectional images of calcification and the stent were analyzed by the color map system (Plaque Map) developed in our laboratory [1].