Trial for Applying Calcium Score in Carotid Stenosis

Abstract

We previously reported the usefulness of three-dimensional (3D) CT angiography for perioperative evaluation of carotid endarterectomy (CEA). Calcification depicted well in the modality has also been studied pathologically. We have pointed out that the microscopically granular type might be relatively softer than the lump/luminar type and that this factor may affect the result of carotid angioplasty and stenting. The aim of the study was to determine the surgical option by analyzing hardness of calcification with calcium scores obtained by 3DCT angiography.
Seventy carotid arteries were examined with 3DCT angiography and 35 plaques were extracted in CEA. Volume, Hounsfield units and calcium scores of calcified lesions were calculated and analyzed by a 3D workstation.
Calcified lesions were classified into 4 groups according to their volume and Hounsfield units. Though large calcification tended to have a relatively bigger difference between maximum and mean CT values, the calcium score seemed to be plotted in proportion to overall hardness of calcification and to enable comprehensive evaluation, which might affect the choice for surgical treatments.