Small lesions in the heart identified at electron beam CT: calcification or noise?
OBJECTIVE
To identify a minimum definition of coronary artery calcification (CAC) at electron beam computed tomography (CT) that would give repeatable results and be accurate as a marker for coronary artery disease.


METHODS
Hyperattenuating (> 130 HU) foci 0.69-3.09 mm2 in area were evaluated for 256 subjects who underwent two sequential electron beam CT examinations to determine the percentage of hyperattenuating foci seen on a first examination that were seen again on a second examination. Accuracies of varying minimum definitions of CAC were determined in 160 subjects who underwent electron beam CT and coronary arteriography.


RESULTS
Hyperattenuating foci more than 2 mm2 in area were seen again at a second examination in more than 50% of cases (P < .0001). At this minimum definition of CAC, the sensitivity and specificity for identifying any angiographically defined coronary artery disease were 82% and 85%, respectively.


CONCLUSIONS
The 2-mm2-area definition of CAC was reliable and provided an accurate indication of coronary artery disease.
Bielak
L F
LF
Department of Epidemiology, University of Michigan, Ann Arbor.
Kaufmann
R B
RB
Moll
P P
PP
McCollough
C H
CH
Schwartz
R S
RS
Sheedy
P F
PF
D000328:Adult; D016477:Artifacts; D002114:Calcinosis / Q000000981:diagnostic imaging*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed