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Coronary Artery Calcium Scoring: Influence of Reconstruction Interval and Reconstruction Increment Using 64-MDCT

Thomas Schlosser1,2, Peter Hunold1, Thomas Voigtländer2, Axel Schmermund2 and Jörg Barkhausen1

1 Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstrasse 55, Essen 45122, Germany.
2 Cardiovascular Center Bethanien, Frankfurt 60389, Germany.


Figure 1
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  		Fig. 1 —Slight but significant negative correlation was found between the total Agatston score and coefficient of variation in all patients (R =-0.55; p <0.01).

 

Figure 2
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  		Fig. 2 —Transverse CT scans in 63-year-old man. Upper row shows CT images (collimation, 0.6 mm; slice thickness, 3 mm; reconstruction increment, 3 mm) of same slice position at different reconstruction intervals, from 50% on left to 70% on right, of the R-R interval in 5% steps. Lower row shows CT images of consecutive slice position at same reconstruction intervals. Two calcified plaques located in proximal left anterior descending artery are clearly detectable using 60%, 65%, and 70% reconstruction intervals, resulting in total Agatston score of 53, 50, and 50, respectively. Mild smearing artifacts are seen in 55% reconstruction (total Agatston score, 42), whereas 50% reconstruction results in a distinct underestimation of Agatston score (19) due to severe smearing artifacts.

 

Figure 3
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  		Fig. 3 —Transverse CT scans in 81-year-old man. Upper row shows CT images (collimation, 0.6 mm; slice thickness, 3 mm; reconstruction increment, 3 mm) of same slice position at different reconstruction intervals, from 50% on left to 70% on right, of the R-R interval in 5% steps. Lower row displays same CT images; calcified plaques are marked in red. Two calcified plaques located in left mainstem and proximal left anterior descending arteries are clearly visualized using 50%, 55%, 60%, and 65% reconstruction intervals, resulting in total Agatston score of 78, 87, 81, and 88, respectively. In 70% reconstruction interval, calcium is deformed and blurred, resulting in overestimation of total Agatston score of 122.

 

Figure 4
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  		Fig. 4A —Graphs of volumetric scores. Graphs show individual volumetric scores of all patients of group A (A) and group B (B) at reconstruction increments of 1.5 and 3.0 mm.

 

Figure 5
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  		Fig. 4B —Graphs of volumetric scores. Graphs show individual volumetric scores of all patients of group A (A) and group B (B) at reconstruction increments of 1.5 and 3.0 mm.

 

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