Should Radiologists Comment on Incidental Findings of Vascular Calcifications Found on Abdominal/Pelvic CT in Patients Less Than 50 Years of Age?

Incidental Vascular Calcifications on CT in Young Patients

“…In other words, the patients with arterial calcifications were more likely to have dyslipidemia and are more likely to experience an adverse cardiovascular outcome. Even though subgroup analysis of the patients with arterial calcifications did not reach statistical significance, there was a trend toward increasing triglycerides and decreasing HDL with increasing calcific burden (1). This may be a promising first step toward identifying an opportunistic screening biomarker for dyslipidemia and cardiovascular risk.…”

“…In this issue of Academic Radiology, Dr. Bernheim et al describe the correlation between incidentally detected calcified abdominopelvic atherosclerosis and cardiovascular disease risk factors in patients 25À50 years old (1). As this is the first study to assess the correlation of incidentally detected abdominopelvic arterial calcifications with cardiovascular risk in younger population, it may pave the way for future opportunities for meaningful risk prediction in a population for whom lifestyle modifications and cardiovascular medication initiation may impact their long-term survival.…”

“…Dyslipidemia (elevated triglycerides and low high-density lipoprotein [HDL]) is one of the components of metabolic syndrome as defined by the World Health Organization and others (5,8). Bernheim et al have identified a significant correlation between the presence of arterial calcifications incidentally detected on abdominopelvic computed tomography (CTs) obtained for abdominal pain in the emergency department of a single tertiary care center and elevated triglycerides and low HDL as well as a trend toward increased total cholesterol, low-density lipoprotein, and triglycerides and lower HDL with increasing arterial calcification burden (1). As such, we may reasonably extrapolate that incidentally detected arterial calcifications may be a biomarker for dyslipidemia.…”

“…Rather than relying on gestalt impressions of the degree of vascular calcifications in this younger population of patients, this study proposes simple reference points for visually categorizing the degree of arterial calcifications. Bernheim classifies mild calcification burden as 1À3 small or 1 large calcification, moderate burden as 4À6 small or 2À3 large calcifications, and severe burden as greater than 6 small or greater than 3 large calcifications (1). The group of patients with arterial calcifications had significantly higher triglycerides and significantly lower HDL, compared to those without arterial calcifications and patients with arterial calcifications were 7 times more likely to suffer a myocardial infarction and 3.5 times more likely to suffer a stroke than those without calcifications in the 6 years following their CT examination (1).…”

“…Bernheim classifies mild calcification burden as 1À3 small or 1 large calcification, moderate burden as 4À6 small or 2À3 large calcifications, and severe burden as greater than 6 small or greater than 3 large calcifications (1). The group of patients with arterial calcifications had significantly higher triglycerides and significantly lower HDL, compared to those without arterial calcifications and patients with arterial calcifications were 7 times more likely to suffer a myocardial infarction and 3.5 times more likely to suffer a stroke than those without calcifications in the 6 years following their CT examination (1). In other words, the patients with arterial calcifications were more likely to have dyslipidemia and are more likely to experience an adverse cardiovascular outcome.…”