Analysis of Calcium in Carotid Plaques With Agatston Scores for Appropriate Selection of Surgical Intervention

Abstract

Background and Purpose-The aim of the study was to determine whether the Agatston calcium score might be applied as a useful tool for evaluation of carotid stenosis. Methods-A total of 124 carotid bifurcations were examined with multidetector row CT. Calcium scores were determined according to the method described by Agatston et al. Results-Agatston scores generally appear appropriate for evaluation of calcified plaques. Calcified lesions with bigger differences between mean and peak Hounsfield unit (HU) in single cases accounted for only 34.3% of those with volume scores under 500 mm 3 , whereas 81.3% (PϽ0.001) for those sized Ͼ500 mm 3 . Conclusions-The Agatston calcium score is useful in evaluating carotid plaques with calcium. We recommend, however, individual analyses for quality (hardness) and quantity (volume) of each large calcified focus (Ͼ500 mm 3 ) by multidetector row CT lesions in order to provide indications for surgical treatment of carotid stenosis, carotid endarterectomy or carotid artery stenting.

MDCT assessment of CAD in type-2 diabetic subjects with diabetic neuropathy: the role of Charcot neuro-arthropathy

“…It could be a possible factor contributing to the lack of difference in calcium score between the two studied groups. The AS has been commonly used for evaluating the calcium of the coronary arteries by CT, while only limited investigations have been performed by this method with the focus on carotid and lower limbs calcification [47][48][49], though carotid and lower limbs atherosclerosis often share patient population and risk factors. Finally, the MDCT-CA scan technique applied in the study with the use of retrospective ECG gating has exposed patients at a considerable and well-known [50] X-ray dose (mean dose: 18±5 mSv).…”

Correlation between carotid bifurcation calcium burden on non-enhanced CT and percentage stenosis, as confirmed by digital subtraction angiography

“…Although a point of debate, some current data suggest that elevated carotid calcium scores may be predictive of future cerebrovascular events [4]. Despite there being promising studies initially that involved the use of EBCT and MDCT for carotid calcium measurement, there is an ongoing debate as to whether calcium scoring is a reliable indicator of cerebrovascular risk detection and in determining the course of management [3,7,36]. One controversy arises from the substantial measurement variability (up to 30%) of the conventional Agatson score if applied to the carotid bifurcation [37].…”

Non-invasive imaging techniques and assessment of carotid vasa vasorum neovascularization: Promises and pitfalls

“…Also, the accuracy of CEUS in plaque analysis decreases for heavily calcified plaques that create acoustic shadows (5,29,39). This is important because acoustic shadowing limits the assessment of stenosis severity and other plaque characteristics (40,41). The use of specialized software, implementing blooming-reducing algorithms, to analyse images with acoustic shadows can mitigate the errors in image evaluation and enhance image quality and detection of VV (23).…”