Coronary Artery Calcium: Absolute Quantification in Nonenhanced and Contrast-enhanced Multi–Detector Row CT Studies

Hong, Cheng; Becker, Christoph; Schoepf, U. Joseph; Ohnesorge, Bernd; Bruening, Roland; Reiser, Maximilian

doi:10.1148/radiol.2232010919

Cited by 182 publications

(101 citation statements)

References 24 publications

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“…Moreover, Hong et al [31] found a very high correlation between coronary calcium scores based on 1.25-mm-section-width CT angiography and traditional 3-mm-section-width unenhanced CT. Finally, we did not examine the contribution of intracranial carotid artery calcifications as seen on routine head CT in addition to or in comparison with extracranial carotid calcium burden for the development of symptoms; future studies looking at this relationship would be of interest.…”

Section: Discussionmentioning

confidence: 99%

Carotid Artery Calcification on CT May Independently Predict Stroke Risk

Nandalur

Baskurt

Hagspiel

et al. 2006

American Journal of Roentgenology

117

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OBJECTIVE-The purpose of our study was to quantitatively evaluate calcified atherosclerotic burden in the cervical carotid arteries using MDCT to determine the relationship of scores with luminal stenosis and symptomatology.MATERIALS AND METHODS-Calcium plaque volume was measured in 106 cervical carotid arteries (53 patients) using MDCT angiography. The study group included 32 asymptomatic patients (mean age, 70.2 ± 8.7 [SD] years; 15 women, 17 men) and 21 patients with ischemic neurologic symptoms (69.6 ± 12.9 years; eight women, 13 men). By vessel, there were 43 high-grade stenotic (≥ 60% by North American Symptomatic Carotid Endarterectomy Trial [NASCET] criteria), 15 moderate-grade stenotic (30-59%), and 44 mild-grade stenotic or normal (0-29%) vessels, with four excluded for prior carotid endarterectomy. Volume scores were calculated by summing the area of calcium in the common and extracranial internal carotid arteries on axial slices and multiplying by the slice increment.RESULTS-Controlling for cardiovascular risk factors and luminal stenosis, we found that scores were significantly related to the occurrence of symptoms (p = 0.003). Even with patient age as a covariant, patients with high-grade stenosis had significantly higher scores than those without highgrade disease (p = 0.004). Moreover, quantitative burden was associated with luminal stenosis on adjusted multivariate analysis (p = 0.034). The specificity and positive predictive value for highgrade luminal narrowing were notably lower on individual vessel analysis than on total score analysis, likely secondary to variability in vascular remodeling.CONCLUSION-Calcium scores in the cervical carotid arteries may represent an independent marker for luminal stenosis and ischemic symptoms. A prospective longitudinal study examining calcium levels and morbidity may be warranted to examine whether burden has a role in risk stratification. KeywordsCT arteriography; calcium; carotid; stroke Vascular calcium deposits have recently become a major research and public interest secondary to increasing evidence of the relationship of calcium scores with atherosclerotic burden and clinical outcome. The prevailing example involves coronary calcium scores measured on CT, which have been associated with luminal stenosis [1], overall coronary atherosclerotic load

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Section: Discussionmentioning

confidence: 99%

Carotid Artery Calcification on CT May Independently Predict Stroke Risk

Nandalur

Baskurt

Hagspiel

et al. 2006

American Journal of Roentgenology

117

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“…In that study, the baseline measurements included the CAC score determined on CT in addition to other clinical markers 20) . In the MESA study, the prevalence of coronary Several parameters for quantifying the degree of CAC employ measurements of the area and density of all foci of calcification, including the Agatston score 3) , volumetric score 17) and calcium mass score 18) . The Agatston score, the most commonly used tool, is calculated based on the sum of the area and density weightings across the coronary arteries.…”

Section: Risk Stratificationmentioning

confidence: 99%

Clinical Implications of the Coronary Artery Calcium Score in Japanese Patients

Yamamoto

Kitagawa

Kihara

2014

JAT

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Coronary artery calcification (CAC) is a well-established surrogate marker of the total burden of coronary atherosclerosis. The CAC score, as measured on coronary computed tomography (CT), is associated with the prevalence of coronary artery disease (CAD) as well as cardiovascular morbidity and mortality. The CAC score is used to reclassify coronary risks in asymptomatic individuals with intermediate risks. However, there are few clinical data regarding the usefulness of the CAC score for identifying high-risk Japanese patients. In this review article, we describe our previous studies of the prognostic value of the CAC score in patients with proven or suspected CAD. In addition, we reanalyzed our previous data for 723 patients with suspected CAD and found both all-cause and cardiovascular disease mortality to be significantly higher among the patients with a CAC score of ≥ 100 than among those with a CAC score of ＜100. Several studies from Japan have also shown that the CAC score is associated with the prevalence of obstructive CAD, as demonstrated on invasive coronary angiography or stress myocardial perfusion imaging. Furthermore, the CAC score provides useful information for performing coronary CT angiography, as asymptomatic patients without CAC are expected to have favorable outcomes. In contrast, the diagnostic accuracy is decreased in patients with a high CAC score (＞400 or 600). In conclusion, the CAC score may have useful clinical applications in symptomatic and asymptomatic Japanese individuals. However, further studies are required to evaluate the prognostic value of this parameter for predicting cardiovascular morbidity and mortality in population-based analyses of asymptomatic Japanese subjects.

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“…Although theoretically better for portability between scanners, this score has not yet undergone sufficient validation (autopsy, histology, outcomes, progression, or angiographic comparison), so its use clinically is premature. 42,43 The retention of the Agatston score has been predicated on the availability of databases for these scores, which include the availability of outcome data so clinicians understand the significance of a certain score. Volume scores are similar, while mass scores tend to be much lower values for a given patient.…”

Section: Coronary Artery Calcified Plaquementioning

confidence: 99%