Correlation of regional distribution and morphological pattern of calcification at CT coronary artery calcium scoring with non-calcified plaque formation and stenosis.
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 >or=50% and non-calcified plaque.


RESULTS
A total of 48/106 patients had stenosis >or=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 >or=50% stenosis and non-calcified plaque (p = 0.04) than calcified nodules.


CONCLUSIONS
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.
Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC 29401, USA.
Christian
C
Thilo
Mulugeta
M
Gebregziabher
Florian B
FB
Mayer
Peter L
PL
Zwerner
Philip
P
Costello
U Joseph
UJ
Schoepf
D000328:Adult; D000368:Aged; D000465:Algorithms; D002114:Calcinosis / Q000000981:diagnostic imaging*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011856:Radiographic Image Enhancement / Q000379:methods; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D014057:Tomography, X-Ray Computed / Q000379:methods*