The Vulnerable Plaque: Recent Advances in Computed Tomography Imaging to Identify the Vulnerable Patient.

PURPOSE OF REVIEW This review aims to summarize the role of coronary computed tomography plaque analysis in identifying high-risk patients and plaques. RECENT FINDINGS In this review, we will describe the histopathological features of a vulnerable plaque as well as the coronary computed tomography characteristics including spotty calcification, low-attenuation fatty core, positive remodeling, and thin fibrous cap. We will also review several studies that assessed features of a vulnerable plaque on non-invasive imaging and evaluated them as risk predictors of future acute coronary events. Multiple recent studies suggested that coronary computed tomography angiography can accurately identify high-risk features of plaque that will predict future events.