Calcifications of the thoracic aorta on extended non-contrast-enhanced cardiac CT

Background: The presence of calcified atherosclerosis in different vascular beds has been associated with a higher risk of mortality. Thoracic aorta calcium (TAC) can be assessed from computed tomography (CT) scans, originally aimed at coronary artery calcium (CAC) assessment. CAC screening improves...

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Autores principales:	Craiem, D., Chironi, G., Casciaro, M.E., Graf, S., Simon, A.
Formato:	JOUR
Materias:	calcium adult Agatston score algorithm aorta arch artery calcification Article blood vessel diameter cardiac imaging cardiovascular risk computed tomography scanner controlled study descending aorta female human major clinical study male middle aged multidetector computed tomography patient coding risk assessment thoracic aorta age aged angiocardiography aorta disease atherosclerosis calcinosis radiography risk factor sex difference Adult Age Factors Aged Aorta, Thoracic Aortic Diseases Atherosclerosis Calcinosis Coronary Angiography Female Humans Male Middle Aged Risk Assessment Risk Factors Sex Factors
Acceso en línea:	http://hdl.handle.net/20.500.12110/paper_19326203_v9_n10_p_Craiem
Aporte de:	Biblioteca Digital - Facultad de Ciencias Exactas y Naturales (UBA) de Universidad de Buenos Aires

id	todo:paper_19326203_v9_n10_p_Craiem
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spelling	todo:paper_19326203_v9_n10_p_Craiem2023-10-03T16:35:39Z Calcifications of the thoracic aorta on extended non-contrast-enhanced cardiac CT Craiem, D. Chironi, G. Casciaro, M.E. Graf, S. Simon, A. calcium adult Agatston score algorithm aorta arch artery calcification Article blood vessel diameter cardiac imaging cardiovascular risk computed tomography scanner controlled study descending aorta female human major clinical study male middle aged multidetector computed tomography patient coding risk assessment thoracic aorta age aged angiocardiography aorta disease atherosclerosis calcinosis radiography risk factor sex difference thoracic aorta Adult Age Factors Aged Aorta, Thoracic Aortic Diseases Atherosclerosis Calcinosis Coronary Angiography Female Humans Male Middle Aged Risk Assessment Risk Factors Sex Factors Background: The presence of calcified atherosclerosis in different vascular beds has been associated with a higher risk of mortality. Thoracic aorta calcium (TAC) can be assessed from computed tomography (CT) scans, originally aimed at coronary artery calcium (CAC) assessment. CAC screening improves cardiovascular risk prediction, beyond standard risk assessment, whereas TAC performance remains controversial. However, the curvilinear portion of the thoracic aorta (TA), that includes the aortic arch, is systematically excluded from TAC analysis. We investigated the prevalence and spatial distribution of TAC all along the TA, to see how those segments that remain invisible in standard TA evaluation were affected. Methods and Results: A total of 970 patients (77% men) underwent extended non-contrast cardiac CT scans including the aortic arch. An automated algorithm was designed to extract the vessel centerline and to estimate the vessel diameter in perpendicular planes. Then, calcifications were quantified using the Agatston score and associated with the corresponding thoracic aorta segment. The aortic arch and the proximal descending aorta, "invisible" in routine CAC screening, appeared as two vulnerable sites concentrating 60% of almost 11000 calcifications. The aortic arch was the most affected segment per cm length. Using the extended measurement method, TAC prevalence doubled from 31% to 64%, meaning that 52% of patients would escape detection with a standard scan. In a stratified analysis for CAC and/or TAC assessment, 111 subjects (46% women) were exclusively identified with the enlarged scan. Conclusions: Calcium screening in the TA revealed that the aortic arch and the proximal descending aorta, hidden in standard TA evaluations, concentrated most of the calcifications. Middle-aged women were more prone to have calcifications in those hidden portions and became candidates for reclassification. © 2014 Craiem et al. JOUR info:eu-repo/semantics/openAccess http://creativecommons.org/licenses/by/2.5/ar http://hdl.handle.net/20.500.12110/paper_19326203_v9_n10_p_Craiem
institution	Universidad de Buenos Aires
institution_str	I-28
repository_str	R-134
collection	Biblioteca Digital - Facultad de Ciencias Exactas y Naturales (UBA)
topic	calcium adult Agatston score algorithm aorta arch artery calcification Article blood vessel diameter cardiac imaging cardiovascular risk computed tomography scanner controlled study descending aorta female human major clinical study male middle aged multidetector computed tomography patient coding risk assessment thoracic aorta age aged angiocardiography aorta disease atherosclerosis calcinosis radiography risk factor sex difference thoracic aorta Adult Age Factors Aged Aorta, Thoracic Aortic Diseases Atherosclerosis Calcinosis Coronary Angiography Female Humans Male Middle Aged Risk Assessment Risk Factors Sex Factors
spellingShingle	calcium adult Agatston score algorithm aorta arch artery calcification Article blood vessel diameter cardiac imaging cardiovascular risk computed tomography scanner controlled study descending aorta female human major clinical study male middle aged multidetector computed tomography patient coding risk assessment thoracic aorta age aged angiocardiography aorta disease atherosclerosis calcinosis radiography risk factor sex difference thoracic aorta Adult Age Factors Aged Aorta, Thoracic Aortic Diseases Atherosclerosis Calcinosis Coronary Angiography Female Humans Male Middle Aged Risk Assessment Risk Factors Sex Factors Craiem, D. Chironi, G. Casciaro, M.E. Graf, S. Simon, A. Calcifications of the thoracic aorta on extended non-contrast-enhanced cardiac CT
topic_facet	calcium adult Agatston score algorithm aorta arch artery calcification Article blood vessel diameter cardiac imaging cardiovascular risk computed tomography scanner controlled study descending aorta female human major clinical study male middle aged multidetector computed tomography patient coding risk assessment thoracic aorta age aged angiocardiography aorta disease atherosclerosis calcinosis radiography risk factor sex difference thoracic aorta Adult Age Factors Aged Aorta, Thoracic Aortic Diseases Atherosclerosis Calcinosis Coronary Angiography Female Humans Male Middle Aged Risk Assessment Risk Factors Sex Factors
description	Background: The presence of calcified atherosclerosis in different vascular beds has been associated with a higher risk of mortality. Thoracic aorta calcium (TAC) can be assessed from computed tomography (CT) scans, originally aimed at coronary artery calcium (CAC) assessment. CAC screening improves cardiovascular risk prediction, beyond standard risk assessment, whereas TAC performance remains controversial. However, the curvilinear portion of the thoracic aorta (TA), that includes the aortic arch, is systematically excluded from TAC analysis. We investigated the prevalence and spatial distribution of TAC all along the TA, to see how those segments that remain invisible in standard TA evaluation were affected. Methods and Results: A total of 970 patients (77% men) underwent extended non-contrast cardiac CT scans including the aortic arch. An automated algorithm was designed to extract the vessel centerline and to estimate the vessel diameter in perpendicular planes. Then, calcifications were quantified using the Agatston score and associated with the corresponding thoracic aorta segment. The aortic arch and the proximal descending aorta, "invisible" in routine CAC screening, appeared as two vulnerable sites concentrating 60% of almost 11000 calcifications. The aortic arch was the most affected segment per cm length. Using the extended measurement method, TAC prevalence doubled from 31% to 64%, meaning that 52% of patients would escape detection with a standard scan. In a stratified analysis for CAC and/or TAC assessment, 111 subjects (46% women) were exclusively identified with the enlarged scan. Conclusions: Calcium screening in the TA revealed that the aortic arch and the proximal descending aorta, hidden in standard TA evaluations, concentrated most of the calcifications. Middle-aged women were more prone to have calcifications in those hidden portions and became candidates for reclassification. © 2014 Craiem et al.
format	JOUR
author	Craiem, D. Chironi, G. Casciaro, M.E. Graf, S. Simon, A.
author_facet	Craiem, D. Chironi, G. Casciaro, M.E. Graf, S. Simon, A.
author_sort	Craiem, D.
title	Calcifications of the thoracic aorta on extended non-contrast-enhanced cardiac CT
title_short	Calcifications of the thoracic aorta on extended non-contrast-enhanced cardiac CT
title_full	Calcifications of the thoracic aorta on extended non-contrast-enhanced cardiac CT
title_fullStr	Calcifications of the thoracic aorta on extended non-contrast-enhanced cardiac CT
title_full_unstemmed	Calcifications of the thoracic aorta on extended non-contrast-enhanced cardiac CT
title_sort	calcifications of the thoracic aorta on extended non-contrast-enhanced cardiac ct
url	http://hdl.handle.net/20.500.12110/paper_19326203_v9_n10_p_Craiem
work_keys_str_mv	AT craiemd calcificationsofthethoracicaortaonextendednoncontrastenhancedcardiacct AT chironig calcificationsofthethoracicaortaonextendednoncontrastenhancedcardiacct AT casciarome calcificationsofthethoracicaortaonextendednoncontrastenhancedcardiacct AT grafs calcificationsofthethoracicaortaonextendednoncontrastenhancedcardiacct AT simona calcificationsofthethoracicaortaonextendednoncontrastenhancedcardiacct
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Calcifications of the thoracic aorta on extended non-contrast-enhanced cardiac CT

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