title: Coronary artery calcium score: influence of the reconstruction interval on cardiac risk stratification in asymptomatic patients using dual-source computed tomography.
abstract: OBJECTIVE
  To evaluate the impact of the reconstruction interval on coronary calcium score and cardiac risk stratification using dual-source computed tomography (DSCT).
  
  
  METHODS
  DSCT coronary calcium scoring was performed in 61 consecutive patients, and five data sets per patient were reconstructed within diastole (50 - 70 % of the R-R interval). The Agatston score, volumetric score and the relative variability were assessed for all reconstructions. To assess the individual cardiovascular risk, patients were assigned to risk groups based on age and gender-matched percentile ranks.
  
  
  RESULTS
  The mean Agatston score was 184.8 ± 377.9 (relative variability 47 % ± 52 %). The mean volumetric score was 164.4 ± 310.1 (relative variability 49 % ± 58 %). There was a negative correlation between the total Agatston score and the relative variability (r = -0.37; p < 0.01). Depending on the reconstruction interval used, 18 predominantly young patients were assigned to more than one risk group.
  
  
  CONCLUSIONS
  Despite the increased temporal resolution of DSCT examinations, the Agatston and volumetric scores depend on the reconstruction time within the cardiac cycle. The fact that the greatest relative variability for both the Agatston score and the volumetric score was found in young patients with small amounts of coronary calcium may result in different treatment strategies for young patients depending on the reconstruction used. Therefore, more accurate risk stratification may require the analysis of multiple reconstruction intervals.
authors.affiliation: Klinik für Kardiologie und Angiologie, Elisabeth Krankenhaus Essen, Essen. christoph.jensen@gmx.de
authors.forename: C J
authors.initials: CJ
authors.lastname: Jensen
authors.forename: M
authors.initials: M
authors.lastname: Jochims
authors.forename: H C
authors.initials: HC
authors.lastname: Eberle
authors.forename: A
authors.initials: A
authors.lastname: Wolf
authors.forename: K
authors.initials: K
authors.lastname: Nassenstein
authors.forename: M
authors.initials: M
authors.lastname: Forsting
authors.forename: O
authors.initials: O
authors.lastname: Bruder
authors.forename: T
authors.initials: T
authors.lastname: Schlosser
mesh_terms: D000368:Aged; D002114:Calcinosis / Q000000981:diagnostic imaging*; D055424:Cardiac-Gated Imaging Techniques / Q000379:methods*; D054893:Cone-Beam Computed Tomography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D003971:Diastole / Q000502:physiology; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*