Abstract
The introduction of dual-slice spiral technique by Elscint in 1992 allowed the imaging of the heart with 3-mm slices within 30 s (a breath-hold). The advantage of double-helical computed tomography (DHCT) over single-slice helical CT is its ability to acquire data twice as fast as single-slice helical CT owing to its two parallel arcs of detectors that are simultaneously irradiated by a single node. Both single- and dual-slice techniques acquire a volume of spatial information over several seconds without electrocardiographic gating. These data can be reconstructed into thin overlapping axial images, with an acquisition time for each image of approx 0.6–1.0 s. The use of overlapping methods compensates for the absence of electrocardiogram (ECG) triggering, enabling the detection of minimal spotty calcific lesions with an area threshold of 0.5 mm2. This technique was further improved by the 4- and 16-slice multidetector spiral techniques, which enable the use of ECG triggering with subsecond slice time. The dual-slice technique of the Twin system (Philips LTD) is a contribution to practical cardiology. The noninvasive detection and measurement of the early stages of atherosclerosis within the wall of the coronary arteries provides the clinician with a new perspective on coronary artery disease (CAD) and adds important information to the current noninvasive methods. This chapter will summarize our experience of using the coronary calcium score in clinical practice.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Stary HC. The development of calcium deposits in atherosclerotic lesions and their persistence after lipid regression. Am J Cardiol 2001;88:16–19
Fuster V. Mechanisms leading to myocardial infarction: insights from studies of vascular biology. Circulation 1994;90:2126–2146.
Shemesh J, Stroh CI, Tenenbaum A, et al. Comparison of coronary calcium in stable angina pectoris and in first acute myocardial infarction utilizing double helical computerized tomography. Am J Cardiol 1998;81:271–275.
Shemesh J, Apter S, Itzchak Y, Motro M. Coronary calcification compared in patients with acute versus in those with chronic coronary events using dual-sector spiral CT. Radiology 2003;226:483–488.
Shemesh J, Apter S, Rozenman J, et al. Calcification of coronary arteries: detection and quantification with double helix CT. Radiology 1995;197:779–783.
Broderick LS, Shemesh J, Wilensky RL, et al. Measurement of coronary artery calcium with double helical CT compared to coronary angiography: evaluation of CT scoring methods, interobserver variation, and reproducibility. AJR Am J Roentgenol 1996;167: 439–444.
Sekiya M, Mukai M, Suzuke M, et al. Clinical significance of the calcification of coronary arteries in patients with angiographically normal coronary arteries. Angiology 1992;43:401–407.
Brahmajee KN, Saint S, Bielak LF, Sonnad SS, Peyser PA, Rubenfire M, Fendrick M. Electron-beam computed tomography in the diagnosis of coronary artery disease: a meta-analysis. Arch Intern Med 2001;161:833–838.
Shemesh J, Weg N, Tenenbaum A et al. Usefulness of spiral computed tomography (dual-slice mode) for the detection of coronary artery calcium in patient with chronic atypical chest pain, in typical angina pectoris, and in asymptomatic subjects with prominent atherosclerotic risk factors. Am J Cardiol 2001;87:226–228.
DeSanctis RW. Clinical manifestations of coronary artery disease: chest pain in women. In: Wenger NK, Speroff L, and Packard B (eds), Cardiovascular Health and Disease in Women. Le Jack Communications, Greenwich, CT: 1993;67.
Hung J, Chaitman BR, Lam J, et al. Non-invasive diagnostic test choices for the evaluation of coronary artery disease in women: a multivariate comparison of cardiac fluoroscopy, exercise electrocardiography, and exercise thallium myocardial scintigraphy. J Am Coll Cardiol 1984;4:8–16.
Niemeyer MG, Van Der Wall EE, Kuyper AF, et al. Discordance of visual and quantitative analysis regarding false negative and false positive test results in thallium-201 myocardial perfusion scintigraphy. Am J Physiol Imaging 1991;6:34–43.
Shemesh J, Tenenbaum A, Fisman EZ, et al. Absence of coronary calcification on double helical CT scans: predictor of angiographic normal coronary arteries in elderly women? Radiology 1996;199: 665–668.
Shemesh J, Fisman EZ, Tenenbaum A, et al. Coronary artery calcification in women with syndrome X: usefulness of double helical CT for detection. Radiology 1997;205:697–700.
Gage JE, Hess OM, Murakami T, et al. Vasoconstriction of stenotic coronary arteries during dynamic exercise in patients with classic angina pectoris: reversibility by nitroglycerin. Circulation 1986;73: 865–876.
Glagov S, Weisenberg E, Zarins CK, Stankunavicius R, Kolettis GJ. Compensatory enlargement of human atherosclerotic coronary arteries. New Engl J Med 1996:316:1371–1375
Stroh CI, Shemesh J, Motro M. Using fast CT to exclude CAD in elderly women (60 and above). N Engl J Med 1996;335(8):595.
Shemesh J, Tenenbaum A, Fisman EZ, et al. Coronary calcium as a reliable tool for differentiating ischemic from nonischemic cardiomyopathy. Am J Cardiol 1995;77:191–194.
Budoff MJ, Shavelle DM, Lamont DH, Kim HT, Akinwale P, Kennedy JM, Brundage BH. Usefulness of electron beam computed tomography scanning for distinguishing ischemic from nonischemic cardiomyopathy. J Am Coll Cardiol 1998; 32(5):1173–1178.
Shemesh J, Apter S, Stroh CI, Itzchak Y, Motro M. Tracking coronary calcification by using dual-section spiral CT: a 3-year follow-up. Radiology 2000;217:461–465.
Schmermund A, Baumgart D, Möhlenkamp S, et al. Natural history and topographic pattern of progression of coronary calcification in symptomatic patients: an electron beam CT study. Arterioscler Thromb Vasc Biol 2001;3:421–426.
Yoon HC, Emerick AM, Hill JA, Gjertson DW, Goldin JG. Calcium begets calcium: progression of coronary artery calcification in asymptomatic subjects. Radiology 2002;224:236–241.
Shemesh J, Apter S, Stolero D, Itzchak Y, Motro M. Annual progression of coronary artery calcium by spiral computed tomography in hypertensive patients without myocardial ischemia but with prominent atherosclerotic risk facors, in patients with previous angina pectoris or acute myocardial infarction which healed, and in patients with coronary events during follow-up. Am J Cardiol 2001; 87:1935–1937.
Motro M, Shemesh J. Calcium channel blocker nifedipine slows down progression of coronary calcification in hypertensive patients compared with diuretics. Hyprtension 2001;37:1410–1413.
Shemesh J, Tenenbaum A, Stroh CI, et al. Double helical CT as a new tool for tracking of allograft atherosclerosis in heart transplant recipients. Invest Radiol 1999;32:503–506.
Barbir M, Lazem F, Bowker T et al. Determinant of transplanted coronary calcium detected by ultrafast computed tomography scanning. Am J Cardiol 1997;79:1606–1609.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2005 Humana Press, Inc., Totowa, NJ
About this chapter
Cite this chapter
Shemesh, J. (2005). Detection and Quantification of Coronary Calcium With Dual-Slice CT. In: Schoepf, U.J. (eds) CT of the Heart. Contemporary Cardiology. Humana Press. https://doi.org/10.1385/1-59259-818-8:091
Download citation
DOI: https://doi.org/10.1385/1-59259-818-8:091
Publisher Name: Humana Press
Print ISBN: 978-1-58829-303-9
Online ISBN: 978-1-59259-818-2
eBook Packages: MedicineMedicine (R0)