Correlation of regional distribution and morphological pattern of calcification at CT coronary artery calcium scoring with non-calcified plaque formation and stenosis

To investigate whether regional calcification patterns at CT coronary artery calcium scoring (CCS) correlate with stenosis and non-calcified plaque formation. We studied 106 patients with quantitative catheter angiography (QCA), CCS, and coronary CT angiography (cCTA). CCS was determined globally and for each artery separately. The morphological pattern of each calcification was classified as calcified nodule, shell-like, or diffuse. cCTA studies were evaluated for non-calcified plaque. The global and regional CCS and the calcification pattern were correlated with stenosis a parts per thousand yen50% and non-calcified plaque. A total of 48/106 patients had stenosis a parts per thousand yen50% on QCA. There was weak correlation (r = 0.36) of the global CCS with stenosis. Correlation was stronger per vessel (r = 0.55-r = 0.67). Shell-like and diffuse calcifications were significantly (p = 0.0001) more frequently associated with a parts per thousand yen50% stenosis and non-calcified plaque (p = 0.04) than calcified nodules. As shown before, the global CCS does not correlate well with stenosis. However, regional calcium distribution and specific patterns of calcification are correlated with stenosis and non-calcified plaque. Thus, the specificity of CT calcium scoring for identifying individuals with obstructive disease could be improved by vessel-based rather than global quantification of calcium and by differentiating specific morphological patterns of calcification.