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Radiology, Vol 192, 631-636, Copyright © 1994 by Radiological Society of North America

ARTICLES

Small lesions in the heart identified at electron beam CT: calcification or noise?

LF Bielak, RB Kaufmann, PP Moll, CH McCollough, RS Schwartz and PF Sheedy 2nd
Department of Epidemiology, University of Michigan, Ann Arbor.

PURPOSE: To identify a minimum definition of coronary artery calcification (CAC) at electron beam computed tomography (CT) that would give repeatable results and be accurate as a marker for coronary artery disease. MATERIALS AND METHODS: Hyperattenuating (> 130 HU) foci 0.69-3.09 mm2 in area were evaluated for 256 subjects who underwent two sequential electron beam CT examinations to determine the percentage of hyperattenuating foci seen on a first examination that were seen again on a second examination. Accuracies of varying minimum definitions of CAC were determined in 160 subjects who underwent electron beam CT and coronary arteriography. RESULTS: Hyperattenuating foci more than 2 mm2 in area were seen again at a second examination in more than 50% of cases (P < .0001). At this minimum definition of CAC, the sensitivity and specificity for identifying any angiographically defined coronary artery disease were 82% and 85%, respectively. CONCLUSION: The 2-mm2- area definition of CAC was reliable and provided an accurate indication of coronary artery disease.


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