Coronary angiography coronary artery calcification: Difference between revisions
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==Overview== | ==Overview== | ||
The [[coronary angiogram]] is fairly insensitive to the presence of lesion [[calcification]], particularly the presence of deep [[vessel]] wall [[calcification]]. [[Intravascular ultrasound]] is much more sensitive in the assessment of [[vessel]] wall [[calcification]]. Conventional [[coronary angiography]] has limited [[sensitivity]] for the detection of smaller amounts of [[calcium]], and has moderate [[sensitivity]] for the detection of extensive [[lesion]] [[calcium]] ([[sensitivity]] 60% and 85% for three- and four-quadrant [[calcium]], respectively).<ref name="pmid7895353">{{cite journal |author=Mintz GS, Popma JJ, Pichard AD, ''et al.'' |title=Patterns of calcification in coronary artery disease. A statistical analysis of intravascular ultrasound and coronary angiography in 1155 lesions |journal=Circulation |volume=91 |issue=7 |pages=1959–65 |year=1995 |month=April |pmid=7895353 |doi= |url=}}</ref> [[Calcification]] is often associated with older [[graft]] age, [[insulin–dependent diabetics]], and [[smoking]].<ref name="pmid15723972">{{cite journal |author=Castagna MT, Mintz GS, Ohlmann P, ''et al.'' |title=Incidence, location, magnitude, and clinical correlates of [[saphenous vein graft]] [[calcification]]: an intravascular [[ultrasound]] and [[angiographic]] study |journal=Circulation |volume=111 |issue=9 |pages=1148–52 |year=2005 |month=March |pmid=15723972 |doi=10.1161/01.CIR.0000157160.69812.55 |url=}}</ref> | The [[coronary angiogram]] is fairly insensitive to the presence of lesion [[calcification]], particularly the presence of deep [[vessel]] wall [[calcification]]. [[Intravascular ultrasound]] is much more sensitive in the assessment of [[vessel]] wall [[calcification]]. Conventional [[coronary angiography]] has limited [[sensitivity]] for the detection of smaller amounts of [[calcium]], and has moderate [[sensitivity]] for the detection of extensive [[lesion]] [[calcium]] ([[sensitivity]] 60% and 85% for three- and four-quadrant [[calcium]], respectively).<ref name="pmid7895353">{{cite journal |author=Mintz GS, Popma JJ, Pichard AD, ''et al.'' |title=Patterns of calcification in coronary artery disease. A statistical analysis of intravascular ultrasound and coronary angiography in 1155 lesions |journal=Circulation |volume=91 |issue=7 |pages=1959–65 |year=1995 |month=April |pmid=7895353 |doi= |url=}}</ref> [[Calcification]] is often associated with older [[graft]] age, [[insulin–dependent diabetics]], and [[smoking]].<ref name="pmid15723972">{{cite journal |author=Castagna MT, Mintz GS, Ohlmann P, ''et al.'' |title=Incidence, location, magnitude, and clinical correlates of [[saphenous vein graft]] [[calcification]]: an intravascular [[ultrasound]] and [[angiographic]] study |journal=Circulation |volume=111 |issue=9 |pages=1148–52 |year=2005 |month=March |pmid=15723972 |doi=10.1161/01.CIR.0000157160.69812.55 |url=}}</ref> | ||
Coronary artery calcification is graded as follows: | |||
* None: no radiopacity. | |||
* Mild: faint radiopacities noted during the cardiac cycles. | |||
* Moderate: dense radioapcities noted only during the cardiac cycle. | |||
* Severe: dense radiopacities noted without cardiac motion before contrast injection generally compromising both sides of the arterial lumen. | |||
==Example== | ==Example== | ||
Revision as of 16:25, 5 September 2013
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
The coronary angiogram is fairly insensitive to the presence of lesion calcification, particularly the presence of deep vessel wall calcification. Intravascular ultrasound is much more sensitive in the assessment of vessel wall calcification. Conventional coronary angiography has limited sensitivity for the detection of smaller amounts of calcium, and has moderate sensitivity for the detection of extensive lesion calcium (sensitivity 60% and 85% for three- and four-quadrant calcium, respectively).[1] Calcification is often associated with older graft age, insulin–dependent diabetics, and smoking.[2]
Coronary artery calcification is graded as follows:
- None: no radiopacity.
- Mild: faint radiopacities noted during the cardiac cycles.
- Moderate: dense radioapcities noted only during the cardiac cycle.
- Severe: dense radiopacities noted without cardiac motion before contrast injection generally compromising both sides of the arterial lumen.
Example
Shown below are an animated image and a static image depicting calcification in the right coronary artery. Encircled in yellow in the image on the right is the calcified lesion. Note the haziness in the calcified lesion.
References
- ↑ Mintz GS, Popma JJ, Pichard AD; et al. (1995). "Patterns of calcification in coronary artery disease. A statistical analysis of intravascular ultrasound and coronary angiography in 1155 lesions". Circulation. 91 (7): 1959–65. PMID 7895353. Unknown parameter
|month=ignored (help) - ↑ Castagna MT, Mintz GS, Ohlmann P; et al. (2005). "Incidence, location, magnitude, and clinical correlates of saphenous vein graft calcification: an intravascular ultrasound and angiographic study". Circulation. 111 (9): 1148–52. doi:10.1161/01.CIR.0000157160.69812.55. PMID 15723972. Unknown parameter
|month=ignored (help)