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Coronary Artery Calcium Scoring Using 16-MDCT and a Retrospective ECG-Gating Reconstruction Algorithm

Jun Horiguchi1, Hideya Yamamoto2, Yuji Akiyama1, Kazushi Marukawa3, Nobuhiko Hirai1 and Katsuhide Ito3

1 Department of Radiology, School of Medicine, Hiroshima University, 1-2-3, Kasumi-cho, Minami-ku, Hiroshima 734-8551, Japan.
2 Department of Molecular and Internal Medicine, Division of Clinical Medical Science, Programs for Applied Biomedicine, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima 734-8551, Japan.
3 Department of Radiology, Division of Medical Intelligence and Informatics, Programs for Applied Biomedicine, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima 734-8551, Japan.



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  		Fig. 1A. —78-year-old woman with atypical chest pain (heart rate, 66 beats per minute). Axial electron beam CT scan of heart shows subtle high density in right coronary artery (arrow) that is judged to be calcification. Calcium score is 1.3. Note pericardial thickening.

 


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  		Fig. 1B. —78-year-old woman with atypical chest pain (heart rate, 66 beats per minute). Axial 16-MDCT scan of heart shows that with traditional threshold of 130 H, coronary calcium is not detected. With threshold of 90 H, calcium score is calculated to be 1 on corresponding area judged as calcification on electron beam CT (A).

 


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  		Fig. 2A. —Scatterplots for electron beam CT and 16-MDCT. For coronary calcium scores, linear correlation follows equation: 16-MDCT score = 7.7 + 1.015 x electron beam CT score (r2 = 0.955). Note that calcium scores are not normally distributed.

 


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  		Fig. 2B. —Scatterplots for electron beam CT and 16-MDCT. For coronary calcium volumes, linear correlation follows equation: 16-MDCT volume = 8.85 + 0.993 x electron beam CT volume (r2 = 0.952).

 


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  		Fig. 2C. —Scatterplots for electron beam CT and 16-MDCT. For coronary calcium masses, linear correlation follows equation: 16-MDCT mass = 7.93 + 1.029 x electron beam CT mass (r2 = 0.977).

 


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  		Fig. 3A. —72-year-old man with anterior chest pain (heart rate, 72 beats per minute). Axial electron beam CT scan of heart shows that no calcium is found in circumflex artery area (arrow).

 


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  		Fig. 3B. —72-year-old man with anterior chest pain (heart rate, 72 beats per minute). Axial 16-MDCT scan of heart shows high-density spot strongly suspected to indicate presence of calcium in circumflex artery (arrow); calcium score with threshold of 130 H is 2.

 


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  		Fig. 4A. —Asymptomatic 53-year-old man (heart rate, 72 beats per minute). Axial electron beam CT scan of heart shows no definite calcium in anterior descending artery area (arrow). However, calcium score is calculated as 3.

 


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  		Fig. 4B. —Asymptomatic 53-year-old man (heart rate, 72 beats per minute). Axial 16-MDCT scan of heart shows high-density spot strongly suspected to indicate calcium in anterior descending artery area (arrow); calcium score with threshold of 130 H is 6.

 

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