Kadriye Orta KILIÇKESMEZ, Özgür KILIÇKESMEZ, Neslihan TAŞDELEN, Duygu KARA, Yüksel IŞIK, ARDA KAYHAN, Bengi GÜRSES, Nevzat GÜRMEN

Incidental detection of coronary artery calcifications on non-cardiac thoracic ct examinations

Giriş: Bilgisayarlı tomografi (BT), floroskopi veya otopside saptanan koroner arter kalsifikasyonları ile okluzif koroner arter hastalığı arasında güçlü ilişkiler tanımlanmıştır. Bu çalışmanın amacı, toraks BT incelemeleri esnasında insidental olarak saptanan koroner kalsifikasyonların sıklığını belirlemek ve risk faktörleri ile korele etmekti. Gereç ve Yöntem: Altı ay süresince toraks BT uygulanan ve ortalama yaşları 62,7 (31-92) olan 113 olgu (72 erkek, 42 kadın hasta) retrospektif olarak değerlendirilmiştir. Toraks BT incelemeleri Siemens Somatom Sensation 16 dedektörlü BT cihazında apeksten toraks bazaline dek, 9 mmlik ardışık kesitlerle elde olunmuş ve koroner arterler kalsifikasyonlar açısından değerlendirilmiştir. Bulgular: On sekiz hastada (15.9%) tek damar, 9 hastada (7.9%) çift damar, 7 hastada (6.2%) üç damar ve 3 hastada (2.6%) dört damar kalsifikasyonu olmak üzere toplam 37 hastada (32.7%) koroner kalsifikasyon belirlendi. Koroner kalsifikasyonların sıklığı hipertansiyon, diabetes mellitus, hiperkolesterolemi, nikotin bağımlılığı ve kardiyomegali ile karşılaştırıldı. Hiperkolesterolemi, kardiyomegali ve erkek cinsiyet ile koroner arter kalsifikasyonları arasında istatistiksel anlamlı farklılık bulundu (p

Non-kardiyak toraks bt incelemelerinde rastlantısal olarak saptanan koroner arter kalsifikasyonları

Objective A strong relationship have been demonstrated between the presence of occlusive coronary artery disease and coronary artery calcifications detected at autopsy, fluoroscopy, or computed tomography (CT). The aim of our study was to evaluate the frequency of incidental coronary artery calcifications during thoracic CT examinations and to correlate them with cardiac risk factors. Materials and Methods: Thoracic CT scans obtained over a pereiod of6 months from 113 patients (72 male and 41 female) with a mean age of 62,7 (31-92 years) were retrospectively evaluated. The thoracic scans were performed using standard 9 mm consecutive slices from the apex to the base of the thorax, using a standard thoracic protocol, on a Siemens 16 channel multislice CT scanner. Coronary arteries were evaluated for calcifications. Results: Thirty-seven patients (32.7%) had coronary calcifications.18 patients (15.9%) had one, 9 patients (7.9%) had two, 7 patients (6.2%) had three, and 3 patients (2.6%) had four with vessel calcifications. The frequency of coronary calcifications was correlated with hypertension, diabetes mellitus, hypercholesterolemia, nicotine abuse, and cardiomegaly. Diabetes mellitus, hypercholesterolemia, cardiomegaly and male gender were significantly associated with coronary calcifications (p<0.05). Conclusion: With the advent of multislice faster CT scanners, coronary artery calcifications are more frequently and easily detected during non-cardiac thoracic CT examinations. This retrospective study showed an increased incidence of coronary calcifications in patients with cardiac risk factors. Among these factors diabetes mellitus, hypercholesterolemia, cardiomegaly and male gender were statistically significant.

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1) Shirazi AS, Nasehi N, Sametzadah M, Saberi H, Shabani MA. Spiral CT scan for detecting coronary artery stenosis. Iran. J Radiol 2005; 3:11-15.
2) Feldman C, Vitola D, Schiavo N. Detection of coronary artery disease based on the calcification index obtained by helical computed tomography. Arq Bras Cardiol 2000;75:471-480.
3) Janowitz WR, Agatston S, Kaplan G, Viamonte M. Differences in prevalence and extent of coronary artery calcium detected by ultrafast computed tomography in asymptomatic men and women. Am J Cardiol 1993; 72: 247-254.
4) Tanenbaum SR, Kondos GT, Veselick KE, Prendergast MR, Brundage BH, Choomka EV. Detection of calcific deposits in coronary arteries by ultrafast computed tomography and correlation with angiography. Am J Cardiol 1989; 63: 870-871.
5) Wong ND, Abrahamson D, Tobis JM, Eisenberg H, Detrano RC. Detection of coronary artery calcium by ultrafast computed tomography and its relation to clinical evidence of coronary artery disease. Am J Cardiol 1994; 73: 223-227.
6) Wexler L, Brundage B, Crouse J, et al. Coronary artery calcification: Pathophysiology, epidemiology, imaging methods, and clinical implications. A statement for health professionals from the American Heart Association. Writing Group. Circulation 1996; 94:1175-1192.
7) Keelan PC, Bielak LF, Ashai K, et al. Long-term prognostic value of coronary calcification detected by electron-beam computed tomography in patients undergoing coronary angiography. Circulation 2001; 104:412-417.
8) Budoff MJ. Prognostic value of coronary artery calcification. JCOM 2001; 8:42-48.
9) Greenland P, LaBree L, Azen SP, et al. Coronary Artery Calcium Score combined with Framingham Score for risk prediction in asymptomatic individuals. JAMA 2003; 291:210-215.
10) Rumberger JA, Brundage BH, Rader DJ. Electron beam computed tomographic coronary calcium scanning: a review and guidelines for use in asymptomatic persons. Mayo Clin Proc 1999;74:243-252.
11) McNamara JJ, Molot MA, Stremple JF, Cutting RT. Coronary artery disease in combat casualties in Vietnam. JAMA 1971; 216: 1185-1187.
12) Callaway MP, Richards P, Goddard P, Rees M. The incidence of coronary artery calcification on standard thoracic CT scans. Br J Radiol 1997; 70: 572-574.
13) Selby JB, Morris PB. Coronary Artery Calcification CT. url:http://emedicine.medscape.com/article/352189-overview
14) Timins ME, Pinsk R, Sider L, Bear G. The functional significance of calcification of coronary arteries as detected on CT. J Thorac Imaging 1991;7:79-82.
15) Shemesh J, Apter S, Rozenman J, et al. Calcification of coronary arteries: detection and quantification with double-helix CT. Radiology 1995;197:779-783.
16) Detrano RC, Wong ND, Doherty TM, et al. Coronary calcium does not accurately predict near-term future coronary events in high-risk adults. Circulation. 1999 May 25;99:2633-2638.