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, whereas 81.3% (P<0.001) for those sized >500 mm. 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 (>500 mm) by multidetector row CT lesions in order to provide indications for surgical treatment of carotid stenosis, carotid endarterectomy or carotid artery stenting. © 2007 American Heart Association, Inc.