Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Dec 1;23(12):1324-1333.
doi: 10.5551/jat.35808. Epub 2016 Jul 9.

Identifying Small Coronary Calcification in Non-Contrast 0.5-mm Slice Reconstruction to Diagnose Coronary Artery Disease in Patients with a Conventional Zero Coronary Artery Calcium Score

Yoji Urabe  1 , Hideya Yamamoto, Toshiro Kitagawa, Hiroto Utsunomiya, Hiroshi Tsushima, Fuminari Tatsugami, Kazuo Awai, Yasuki Kihara
Affiliations

Identifying Small Coronary Calcification in Non-Contrast 0.5-mm Slice Reconstruction to Diagnose Coronary Artery Disease in Patients with a Conventional Zero Coronary Artery Calcium Score

Yoji Urabe et al. J Atheroscler Thromb. .

Abstract

Aims: In a new-generation computed tomography (CT) scanner, coronary artery calcium (CAC) scores were measured using 3.0-mm slice reconstruction images originally acquired with 0.5 mm thickness scans in a single beat. This study investigated the usefulness of thin-slice (0.5 mm) reconstruction for identifying small calcifications in coronary arteries and evaluated the association with coronary plaques and stenosis compared to conventional 3.0-mm reconstruction images.

Methods: We evaluated 132 patients with zero CAC scores in conventional 3.0-mm Agatston method using a 320-slice CT. Then, 0.5-mm slice reconstruction was performed to identify small calcifications. The presence of stenosis and coronary plaques was assessed using coronary CT angiography.

Results: In total, 22 small calcifications were identified in 18 patients. There were 28 (21%) patients with any (≥ 25%) stenosis (34 lesions). Forty-seven coronary plaques were found in 33 patients (25%), including 7 calcified plaques in 7 patients (5%), 34 noncalcified plaques in 27 patients (20%), and 6 partially calcified plaques in 5 patients (4%). Patients with small calcifications had a significantly higher prevalence of noncalcified or partially calcified plaques (83% vs 14%; p＜0.001) and obstructive stenosis (33% vs 5.2%; p＜0.001) compared to those without small calcifications. The addition of small calcifications to the coronary risk factors when diagnosing stenosis significantly improved the diagnostic value.

Conclusion: Small calcifications detected by thin-slice 0.5-mm reconstruction are useful for distinguishing coronary atherosclerotic lesions in patients with zero CAC scores from conventional CT reconstruction.

PubMed Disclaimer

Figures

Fig. 1.
Fig. 1.
Representative case of a 58-year-old man who had a zero coronary artery calcium score but also had a small calcification; non-contrast scan of the proximal left anterior descending artery (LAD) with a conventional 3.0-mm slice (A) and a 0.5-mm slice (B). Volume rendering (C) and curved multiplanar construction (D) images in coronary computed tomography angiography showed obstructive stenosis in the proximal LAD (arrow).
Fig. 2.
Fig. 2.
Prevalence of stenosis or plaques in coronary computed tomography angiography according to the presence (solid bar) or absence (open bar) of small calcifications.
Fig. 3.
Fig. 3.
Incremental diagnostic values of small calcifications in addition to coronary risk factors for identifying patients with (A) noncalcified plaques (NCPs) and/or partially calcified plaques (PCPs), (B) any stenosis (≥25%), or (C) obstructive stenosis (≥50%). Coronary risk factors included age, sex, hypertension, dyslipidemia, diabetes mellitus, and current smoking.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Agatston AS, Janowitz WR, Hildner FJ, Zusmer NR, Viamonte M, Jr, Detrano R: Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol, 1990; 15: 827-832 - PubMed
    1. Budoff MJ, Georgiou D, Brody A, Agatston AS, Kennedy J, Wolfkiel C, Stanford W, Shields P, Lewis RJ, Janowitz WR, Rich S, Brundage BH: Ultrafast computed tomography as a diagnostic modality in the detection of coronary artery disease: a multicenter study. Circulation, 1996; 93: 898-904 - PubMed
    1. Yamamoto H, Kitagawa T, Kihara Y: Clinical implications of the coronary artery calcium score in Japanese patients. J Atheroscler Thromb, 2014; 21: 1101-1108 - PubMed
    1. Detrano R, Guerci AD, Carr JJ, Bild DE, Burke G, Folsom AR, Liu K, Shea S, Szklo M, Bluemke DA, O'Leary DH, Tracy R, Watson K, Wong ND, Kronmal RA: Coronary calcium as a predictor of coronary events in four racial or ethnic groups. New Engl J Med, 2008; 358: 1336-1345 - PubMed
    1. Budoff MJ, Shaw LJ, Liu ST, Weinstein SR, Mosler TP, Tseng PH, Flores FR, Callister TQ, Raggi P, Berman DS: Long-term prognosis associated with coronary calcification: observations from a registry of 25,253 patients. J Am Coll Cardiol, 2007; 49: 1860-1870 - PubMed