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(3), whereas 81.3% (P<0.001) for those sized >500 mm(3).

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(3)) by multidetector row CT lesions in order to provide indications for surgical treatment of carotid stenosis, carotid endarterectomy or carotid artery stenting.