[Imaging of coronary atherosclerotic plaque].

Selective coronary angiography allows the precise definition of highly stenotic coronary lesions and therefore remains the basis for catheter-based or surgical myocardial revascularization. However, the accumulation of atherosclerotic plaque in the coronary arterial wall begins much earlier than the development of luminal stenosis. In fact, most acute coronary syndromes are initiated by sudden disruption of atherosclerotic plaques that caused neither significant stenosis nor angina pectoris prior to the event. These early, but potentially vulnerable, lesions are therefore the topic of intensive research but their description with angiography alone is incomplete. Invasive, tomographic imaging modalities, in particular intravascular ultrasound, allow direct visualization of the atherosclerotic plaque and therefore supplement angiography. These techniques have advanced our understanding of coronary artery disease (CAD) progression and stability but are limited because of their invasive character. Current developments in particular of computed tomography already allow the non-invasive imaging of coronary arteries and may have an important role in the early identification of CAD and the prevention of its complications.