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Correlation of regional distribution and morphological pattern of calcification at CT coronary artery calcium scoring with non-calcified plaque formation and stenosis

  • Cardiac
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Abstract

Objective

To investigate whether regional calcification patterns at CT coronary artery calcium scoring (CCS) correlate with stenosis and non-calcified plaque formation.

Methods

We studied 106 patients with quantitative catheter angiography (QCA), CCS, and coronary CT angiography (cCTA). CCS was determined globally and for each artery separately. The morphological pattern of each calcification was classified as calcified nodule, shell-like, or diffuse. cCTA studies were evaluated for non-calcified plaque. The global and regional CCS and the calcification pattern were correlated with stenosis ≥50% and non-calcified plaque.

Results

A total of 48/106 patients had stenosis ≥50% on QCA. There was weak correlation (r = 0.36) of the global CCS with stenosis. Correlation was stronger per vessel (r = 0.55–r = 0.67). Shell-like and diffuse calcifications were significantly (p = 0.0001) more frequently associated with ≥50% stenosis and non-calcified plaque (p = 0.04) than calcified nodules.

Conclusion

As shown before, the global CCS does not correlate well with stenosis. However, regional calcium distribution and specific patterns of calcification are correlated with stenosis and non-calcified plaque. Thus, the specificity of CT calcium scoring for identifying individuals with obstructive disease could be improved by vessel-based rather than global quantification of calcium and by differentiating specific morphological patterns of calcification.

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Acknowledgements

This study received research support from Siemens Medical Solutions and Bracco. PLZ receives research support from Boehringer-Ingelheim, Bristol Myers Squib, Bracco, and Siemens. PC is a medical consultant for Bracco and receives research support from Siemens. UJS is a medical consultant for and receives research support from Bayer-Schering, Bracco, General Electric, Medrad, and Siemens.

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Authors and Affiliations

  1. Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, 25 Courtenay Drive, MSC 226, Charleston, SC, 29401, USA

    Christian Thilo, Florian B. Mayer, Peter L. Zwerner, Philip Costello & U. Joseph Schoepf

  2. Department of Medicine, Division of Cardiology, Medical University of South Carolina, Charleston, SC, USA

    Christian Thilo, Peter L. Zwerner & U. Joseph Schoepf

  3. Department of Cardiology, Klinikum Augsburg, Herzzentrum Augsburg-Schwaben, Augsburg, Germany

    Christian Thilo

  4. Department of Biostatistics, Bioinformatics and Epidemiology, Medical University of South Carolina, Charleston, SC, USA

    Mulugeta Gebregziabher

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  1. Christian Thilo
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  2. Mulugeta Gebregziabher
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  3. Florian B. Mayer
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  4. Peter L. Zwerner
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  6. U. Joseph Schoepf
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Correspondence to U. Joseph Schoepf.

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Thilo, C., Gebregziabher, M., Mayer, F.B. et al. Correlation of regional distribution and morphological pattern of calcification at CT coronary artery calcium scoring with non-calcified plaque formation and stenosis. Eur Radiol 20, 855–861 (2010). https://doi.org/10.1007/s00330-009-1630-0

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  • DOI: https://doi.org/10.1007/s00330-009-1630-0

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