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      KCI등재 SCOPUS

      비 조영증강 비 심전도동기 흉부 CT에서 발견되는 심혈관계 석회화의 임상적 가치 = Clinical Value of Cardiovascular Calcifications on Non-Enhanced, Non-ECG-Gated Chest CT

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      https://www.riss.kr/link?id=A106843730

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      국문 초록 (Abstract)

      심혈관계 석회화는 다양한 심혈관계 질환에서 나타나며 심혈관 사건 발생의 표지자의 역할을 한다. CT의 기술이 발전함에 따라 심전도동기 CT뿐만이 아닌 비 심전도동기 CT에서도심혈관계 석...

      심혈관계 석회화는 다양한 심혈관계 질환에서 나타나며 심혈관 사건 발생의 표지자의 역할을 한다. CT의 기술이 발전함에 따라 심전도동기 CT뿐만이 아닌 비 심전도동기 CT에서도심혈관계 석회화를 평가하는 것이 가능해졌다. 이번 종설에서는 비 조영증강 비 심전도동기흉부 CT에서 발견되는 심혈관계 석회화를 심혈관 사건 발생과 연관되었다고 알려진 3가지석회화(관상동맥, 흉부 대동맥, 판막 석회화)에 대해 자세히 살펴보고 추가적으로 우연적으로 발견될 수 있는 심막 석회화에 대해서도 간단히 기술하였다. 우리나라에서 2019년 하반기부터 폐암 검진이 시작되면서 고령 흡연자의 비 조영증강 비 심전도동기 저선량 CT의 영상의 수가 늘어나고 있고 이에 우연히 발견되는 심혈관계 석회화도 늘어나고 있다. 그러므로비 조영증강 비 심전도동기 흉부 CT에서 발견되는 심혈관계 석회화의 의미를 이해하고 적절히 보고하는 것이 영상의학과 의사에게 중요할 것이다.

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      다국어 초록 (Multilingual Abstract)

      Cardiovascular calcifications can occur in various cardiovascular diseases and can serve as a biomarker for cardiovascular event prediction. Advances in CT have enabled evaluation of calcifications in cardiovascular structures not only on ECG-gated CT...

      Cardiovascular calcifications can occur in various cardiovascular diseases and can serve as a biomarker for cardiovascular event prediction. Advances in CT have enabled evaluation of calcifications in cardiovascular structures not only on ECG-gated CT but also on non-ECG-gated CT. Therefore, many studies have been conducted on the clinical relevance of cardiovascular calcifications in patients. In this study, we divided cardiovascular calcifications into three classes, i.e., coronary artery, thoracic aorta, and cardiac valve calcifications, which are closely associated with cardiovascular events. Further, we briefly described pericardial calcifications, which can be found incidentally. Since the start of lung cancer screening in Korea in the second half of 2019, the number of non-enhanced, non-ECG-gated, low-dose chest CT has been increasing, and the number of incidentally found cardiovascular calcifications has also been increasing.
      Therefore, understanding the relevance of cardiovascular calcifications on non-enhanced, non- ECG-gated, low-dose chest CT and their proper reporting are important for radiologists.

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      참고문헌 (Reference)

      1 윤순호, "국가폐암검진 CT에서의 폐암 외 중요 소견" 대한영상의학회 80 (80): 837-848, 2019

      2 Pawade T, "Why and how to measure aortic valve calcification in patients with aortic stenosis" 12 : 1835-1848, 2019

      3 Xie X, "Validation and prognosis of coronary artery calcium scoring in nontriggered thoracic computed tomography : systematic review and meta-analysis" 6 : 514-521, 2013

      4 Kianoush S, "Thoracic extra-coronary calcification for the prediction of stroke : the Multi-Ethnic Study of Atherosclerosis" 267 : 61-67, 2017

      5 Hermann DM, "Thoracic aortic calcification is associated with incident stroke in the general population in addition to established risk factors" 16 : 684-690, 2014

      6 Budoff MJ, "Thoracic aortic calcification and coronary heart disease events : the multi-ethnic study of atherosclerosis(MESA)" 215 : 196-202, 2011

      7 Desai MY, "Thoracic aortic calcification : diagnostic, prognostic, and management considerations" 11 : 1012-1026, 2018

      8 Eijsvoogel NG, "The role of standard non-ECG gated chest CT in cardiac assessment : design and rationale of the Cardiac Pathologies in standard chest CT(CaPaCT)study" 2 : 9-, 2018

      9 Lessmann N, "Sex differences in coronary artery and thoracic aorta calcification and their association with cardiovascular mortality in heavy smokers" 12 : 1808-1817, 2019

      10 Takasu J, "Relationship between coronary artery and descending thoracic aortic calcification as detected by computed tomography : the Multi-Ethnic Study of Atherosclerosis" 204 : 440-446, 2009

      1 윤순호, "국가폐암검진 CT에서의 폐암 외 중요 소견" 대한영상의학회 80 (80): 837-848, 2019

      2 Pawade T, "Why and how to measure aortic valve calcification in patients with aortic stenosis" 12 : 1835-1848, 2019

      3 Xie X, "Validation and prognosis of coronary artery calcium scoring in nontriggered thoracic computed tomography : systematic review and meta-analysis" 6 : 514-521, 2013

      4 Kianoush S, "Thoracic extra-coronary calcification for the prediction of stroke : the Multi-Ethnic Study of Atherosclerosis" 267 : 61-67, 2017

      5 Hermann DM, "Thoracic aortic calcification is associated with incident stroke in the general population in addition to established risk factors" 16 : 684-690, 2014

      6 Budoff MJ, "Thoracic aortic calcification and coronary heart disease events : the multi-ethnic study of atherosclerosis(MESA)" 215 : 196-202, 2011

      7 Desai MY, "Thoracic aortic calcification : diagnostic, prognostic, and management considerations" 11 : 1012-1026, 2018

      8 Eijsvoogel NG, "The role of standard non-ECG gated chest CT in cardiac assessment : design and rationale of the Cardiac Pathologies in standard chest CT(CaPaCT)study" 2 : 9-, 2018

      9 Lessmann N, "Sex differences in coronary artery and thoracic aorta calcification and their association with cardiovascular mortality in heavy smokers" 12 : 1808-1817, 2019

      10 Takasu J, "Relationship between coronary artery and descending thoracic aortic calcification as detected by computed tomography : the Multi-Ethnic Study of Atherosclerosis" 204 : 440-446, 2009

      11 Sverzellati N, "Relationship and prognostic value of modified coronary artery calcium score, FEV1, and emphysema in lung cancer screening population : the MILD trial" 262 : 460-467, 2012

      12 National Lung Screening Trial Research Team, "Reduced lung-cancer mortality with low-dose computed tomographic screening" 365 : 395-409, 2011

      13 Lee HY, "Quantification of aortic valve calcifications detected during lung cancer-screening CT helps stratify subjects necessitating echocardiography for aortic stenosis diagnosis" 95 : e3710-, 2016

      14 Willemink MJ, "Prognostic value of heart valve calcifications for cardiovascular events in a lung cancer screening population" 31 : 1243-1249, 2015

      15 Weiss SA, "Postoperative pericardial calcification causing diastolic coronary compression" 90 : 1001-1004, 2010

      16 Shaw M, "Pericardial calcification: an uncommon presentation of rheumatic heart disease" 2018

      17 Shemesh J, "Ordinal scoring of coronary artery calcifications on low-dose CT scans of the chest is predictive of death from cardiovascular disease" 257 : 541-548, 2010

      18 Tison GH, "Multisite extracoronary calcification indicates increased risk of coronary heart disease and all-cause mortality : the Multi-Ethnic Study of Atherosclerosis" 9 : 406-414, 2015

      19 Lanzer P, "Medial vascular calcification revisited : review and perspectives" 35 : 1515-1525, 2014

      20 Zhu D, "Mechanisms and clinical consequences of vascular calcification" 3 : 95-, 2012

      21 Mahnken AH, "MDCT detection of mitral valve calcification : prevalence and clinical relevance compared with echocardiography" 188 : 1264-1269, 2007

      22 Nair CK, "Long-term follow-up of patients with echocardiographically detected mitral anular calcium and comparison with age-and sex-matched control subjects" 63 : 465-470, 1989

      23 Jairam PM, "Incidental imaging findings from routine chest CT used to identify subjects at high risk of future cardiovascular events" 272 : 700-708, 2014

      24 Nguyen T, "Incidental findings of pericardial calcification" 2 : 455-458, 2014

      25 Kuetting D, "Incidental cardiac findings in non-electrocardiogram-gated thoracic computed tomography of intensive care unit patients : assessment of prevalence and underreporting" 33 : 168-175, 2018

      26 Wan YL, "Impact of filter convolution and displayed field of view on estimation of coronary Agatston scores in low-dose lung computed tomography" 236 : 451-457, 2017

      27 Wang Y, "Imaging cardiovascular calcification" 7 : e008564-, 2018

      28 Kavousi M, "Evaluation of newer risk markers for coronary heart disease risk classification : a cohort study" 156 : 438-444, 2012

      29 Secchi F, "Detection of incidental cardiac findings in noncardiac chest computed tomography" 96 : e7531-, 2017

      30 Kim SM, "Coronary calcium screening using low-dose lung cancer screening : effectiveness of MDCT with retrospective reconstruction" 190 : 917-922, 2008

      31 Greenland P, "Coronary calcium score and cardiovascular risk" 72 : 434-447, 2018

      32 Callister TQ, "Coronary artery disease : improved reproducibility of calcium scoring with an electron-beam CT volumetric method" 208 : 807-814, 1998

      33 Suh YJ, "Coronary artery calcium severity grading on non-ECG-gated low-dose chest computed tomography : a multiple-observer study in a nationwide lung cancer screening registry" 2020

      34 Thomas CK, "Coronary artery calcium scoring with multislice computed tomography : in vitro assessment of a low tube voltage protocol" 41 : 668-673, 2006

      35 Blaha MJ, "Coronary artery calcium scoring : is it time for a change in methodology" 10 : 923-937, 2017

      36 Jacobs PC, "Coronary artery calcium can predict all-cause mortality and cardiovascular events on low-dose CT screening for lung cancer" 198 : 505-511, 2012

      37 Yoon HC, "Coronary artery calcium : alternate methods for accurate and reproducible quantitation" 4 : 666-673, 1997

      38 McCollough CH, "Coronary artery calcium : a multi-institutional, multimanufacturer international standard for quantification at cardiac CT" 243 : 527-538, 2007

      39 Rasmussen T, "Coronary artery calcification detected in lung cancer screening predicts cardiovascular death" 49 : 159-167, 2015

      40 Budoff MJ, "Coronary artery and thoracic calcium on noncontrast thoracic CT scans : comparison of ungated and gated examinations in patients from the COPD Gene cohort" 5 : 113-118, 2011

      41 Wu MT, "Coronary arterial calcification on low-dose ungated MDCT for lung cancer screening : concordance study with dedicated cardiac CT" 190 : 923-928, 2008

      42 Deprez FC, "Controversies about effects of low-kilovoltage MDCT acquisition on Agatston calcium scoring" 7 : 58-61, 2013

      43 Jacobs PC, "Comparing coronary artery calcium and thoracic aorta calcium for prediction of all-cause mortality and cardiovascular events on low-dose non-gated computed tomography in a high-risk population of heavy smokers" 209 : 455-462, 2010

      44 Hecht H, "Clinical indications for coronary artery calcium scoring in asymptomatic patients : expert consensus statement from the Society of Cardiovascular Computed Tomography" 11 : 157-168, 2017

      45 Hoffmann U, "Cardiovascular event prediction and risk reclassification by coronary, aortic, and valvular calcification in the Framingham Heart Study" 5 : e003144-, 2016

      46 Gondrie MJ, "Cardiovascular disease : prediction with ancillary aortic findings on chest CT scans in routine practice" 257 : 549-559, 2010

      47 Van Hamersvelt RW, "Cardiac valve calcifications on low-dose unenhanced ungated chest computed tomography : inter-observer and inter-examination reliability, agreement and variability" 24 : 1557-1564, 2014

      48 Kanza RE, "Cardiac findings on non-gated chest computed tomography : a clinical and pictorial review" 85 : 435-451, 2016

      49 Eisen A, "Calcification of the thoracic aorta as detected by spiral computed tomography among stable angina pectoris patients : association with cardiovascular events and death" 118 : 1328-1334, 2008

      50 Iribarren C, "Calcification of the aortic arch : risk factors and association with coronary heart disease, stroke, and peripheral vascular disease" 283 : 2810-2815, 2000

      51 Meissner I, "Atherosclerosis of the aorta : risk factor, risk marker, or innocent bystander? A prospective population-based transesophageal echocardiography study" 44 : 1018-1024, 2004

      52 Cho IJ, "Association of thoracic aorta calcium score with left ventricular hypertrophy and clinical outcomes in patients with severe aortic stenosis after aortic valve replacement" 103 : 74-81, 2017

      53 Cho IJ, "Association of thoracic aorta calcium score with exercise blood pressure response and clinical outcomes in elderly individuals : differential impact of aorta calcification compared with coronary artery calcification" 5 : e003131-, 2016

      54 Chiles C, "Association of coronary artery calcification and mortality in the national lung screening trial : a comparison of three scoring methods" 276 : 82-90, 2015

      55 Kucharczyk MJ, "Assessing the impact of incidental findings in a lung cancer screening study by using low-dose computed tomography" 62 : 141-145, 2011

      56 Churchill TW, "Ascending and descending thoracic aorta calcification in type 2 diabetes mellitus" 9 : 373-381, 2015

      57 Owens DS, "Aortic valve calcium independently predicts coronary and cardiovascular events in a primary prevention population" 5 : 619-625, 2012

      58 Cowell SJ, "Aortic valve calcification on computed tomography predicts the severity of aortic stenosis" 58 : 712-716, 2003

      59 Greenland P, "ACCF/AHA 2007 clinical expert consensus document on coronary artery calcium scoring by computed tomography in global cardiovascular risk assessment and in evaluation of patients with chest pain : a report of the American College of Cardiology Foundation Clinical Expert Consensus Task Force(ACCF/AHA Writing Committee to Update the 2000 Expert Consensus Document on Electron Beam Computed Tomography)developed in collaboration with the Society of Atherosclerosis Imaging and Prevention and the Society of Cardiovascular Computed Tomography" 49 : 378-402, 2007

      60 Grundy SM, "2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the management of blood cholesterol : a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines" 139 : e1082-, 2019

      61 Hecht HS, "2016 SCCT/STR guidelines for coronary artery calcium scoring of noncontrast noncardiac chest CT scans : a report of the Society of Cardiovascular Computed Tomography and Society of Thoracic Radiology" 11 : 74-84, 2017

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