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Coronary artery calcium score on low-dose computed tomography for lung cancer screening

World Journal of Radiology 2014年第6期6卷 381-387页

作者： Teresa Arcadi Erica Maffei Nicola Sverzellati Cesare Mantini Andrea I Guaricci Carlo Tedeschi Chiara Martini Ludovico La Grutta filippo cademartiri Department of Radiology SDN Foundation IRCCS 80131 Naples Italy Cardio-vascular Imaging Unit Department of Radiology Giovanni XXIII Clinic Monas-tier di Treviso 31050 Treviso Italy Department of Radiology Erasmus Medical Center University Rotterdam 3015 CE Ro-tterdam The Netherlands Department of Radiology Azienda Ospeda-liero-Universitaria 43100 Parma Italy Department of Radiology Università di Chieti 66100 Chieti Italy Department of Cardiology Università di Foggia 71121 Foggia Italy Department of Cardiology San Gennaro Hospi-tal Naples 80136 Napoli Italy Department of Radiology University of Palermo Italy

AIM: To evaluate the feasibility of coronary artery calcium score(CACS) on low-dose non-gated chest CT(ngCCT).METHODS: Sixty consecutive individuals(30 males; 73 ± 7 years) scheduled for risk stratification by means of unenhanced ECG-triggered cardiac computed to-mography(gCCT) underwent additional unenhanced ngCCT. All CT scans were performed on a 64-slice CT scanner(Somatom Sensation 64 Cardiac, Siemens, Germany). CACS was calculated using conventional methods/scores(Volume, Mass, Agatston) as previ-ously described in literature. The CACS value obtained were compared. The Mayo Clinic classification was used to stratify cardiovascular risk based on Agatston CACS. Differences and correlations between the two methods were compared. A P-value 0 in the ngCCT. Of the 3 patients with 1-10 Agatston score on gCCT, 1(33%) showed an Agatston score of 0 in the ngCCT. Overall, 23(38%) patients were reclassified in a different car-diovascular risk category, mostly(18/23; 78%) shifting to a lower risk in the ngCCT. The estimated radiation dose was significantly higher for gCCT(DLP 115.8 ± 50.7 vs 83.8 ± 16.3; Effective dose 1.6 ± 0.7 mSv vs 1.2 ± 0.2 mSv; P < 0.01).CONCLUSION: CACS assessment is feasible on ngCCT; the variability of CACS values and the associated re-stratification of patients in cardiovascular risk groups should be taken into account.

关键词： Coronary artery calcium score Lung cancer screening High-resolution computed tomography unenhanced chest computed tomography Cardiovascular risk stratification

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Plaque imaging with CT coronary angiography:Effect of intra-vascular attenuation on plaque type classification

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World Journal of Radiology 2012年第6期4卷 265-272页

作者： Erica Maffei Chiara Martini Teresa Arcadi Alberto Clemente Sara Seitun Alessandra Zuccarelli Tito Torri Nico R Mollet Alexia Rossi Onofrio Catalano Giancarlo Messalli filippo cademartiri Cardiovascular Imaging Unit Giovanni XXIII Hospital31050 Monastier di TrevisoTrevisoItaly Department of Radiology Academic Hospital of Parma43100 ParmaItaly Department of Radiology Ospedale di Carrara54033 CarraraItaly Department of Radiology Erasmus Medical Center University3015 CE RotterdamThe Netherlands Filippo Cademartiri Department of Radiology SDN FoundationIRCCS80143 NaplesItaly Department of Radiology Erasmus Medical Center University3015 CE RotterdamThe Netherlands

AIM: To assess the attenuation of non-calcified atherosclerotic coronary artery plaques with computed tomography coronary angiography (CTCA). METHODS: Four hundred consecutive patients underwent CTCA (Group 1: 200 patients, Sensation 64 Cardiac, Siemens; Group 2: 200 patients, VCT GE Healthcare, with either Iomeprol 400 or Iodixanol 320, respectively) for suspected coronary artery disease (CAD). CTCA was performed using standard protocols. Image quality (score 0-3), plaque (within the accessible non-calcified component of each non-calcified/mixed plaque) and coronary lumen attenuation were measured. Data were compared on a per-segment/per-plaque basis. Plaques were classified as fibrous vs lipid rich based on different attenuation thresholds. A P < 0.05 was considered significant. RESULTS: In 468 atherosclerotic plaques in Group 1 and 644 in Group 2, average image quality was 2.96 ± 0.19 in Group 1 and 2.93 ± 0.25 in Group 2 (P ≥ 0.05). Coronary lumen attenuation was 367 ± 85 Hounsfield units (HU) in Group 1 and 327 ± 73 HU in Group 2 (P < 0.05); non-calcified plaque attenuation was 48 ± 23 HU in Group 1 and 39 ± 21 HU in Group 2 (P < 0.05). Overall signal to noise ratio was 15.6 ± 4.7 in Group 1 and 21.2 ± 7.7 in Group 2 (P < 0.01). CONCLUSION: Higher intra-vascular attenuation modifies significantly the attenuation of non-calcified coronary plaques. This results in a more difficult characterization between lipid rich vs fibrous type.

关键词： Computed tomography coronary angiography Coronary artery plaque Plaque characterization Contrast material Lumen enhancement

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