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Intracranial Carotid Calcification on Cranial Computed Tomography: Visual Scoring Methods, Semiautomated Scores, and Volume Measurements in Patients With Stroke.

Subedi D, Zishan US, Chappell F, Gregoriades ML, Sudlow C, Sellar R, Wardlaw J - Stroke (2015)

Bottom Line: Intracranial internal carotid artery calcification increased with age by all measures (eg, visual score, Spearman ρ=0.4; P=0.005).Visual scores correlate highly with quantitative intracranial internal carotid artery calcification measures, with excellent observer agreements.Visual intracranial internal carotid artery scores could be a rapid and practical method for epidemiological studies.

View Article: PubMed Central - PubMed

Affiliation: From the Department of Clinical Radiology, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom (D.S., U.S.Z., M.-L.G.); Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom (F.C., C.S., R.S., J.W.); and Brain Research Imaging Centre, Scottish Imaging Network-A Platform for Scientific Excellence (SINAPSE) Collaboration, Edinburgh, United Kingdom (R.S., J.W.).

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A, Measurement of internal carotid artery (ICA) calcification by semiquantitative methods. A region of interest is drawn around the calcified artery in a wide window setting, from the petrous apex to the internal carotid bifurcation. B, Modified Woodcock visual calcium score. Data derived from Woodcock et al.16 Assessment done per side on each slice and then the slice scores are summed to give an overall calcium grade for each ICA.16
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Figure 1: A, Measurement of internal carotid artery (ICA) calcification by semiquantitative methods. A region of interest is drawn around the calcified artery in a wide window setting, from the petrous apex to the internal carotid bifurcation. B, Modified Woodcock visual calcium score. Data derived from Woodcock et al.16 Assessment done per side on each slice and then the slice scores are summed to give an overall calcium grade for each ICA.16

Mentions: To calculate Agatston score, the software identifies calcifications in the arteries within a region of interest (Figure 1A) in every slice as areas with density >130 HU. At least 3 contiguous pixels with HU>130 are registered as calcification. Area of each of these calcifications is multiplied by a cofactor, which depends on the peak density of the individual plaque (130–199 HU=1; 200–299 HU=2; 300–399 HU=3; and >400 HU=4). Thus, Agatston score is a measure of calcification weighted to a cofactor of peak density of individual plaques. Care was taken to draw the region of interest (Figure 1A) around carotid calcifications on bone window setting to exclude bone from the region of interest, and the readers were allowed to manipulate the window level and width to avoid contamination from adjacent bone. Each ICA was assessed from the petrous apex to the terminal bifurcation (cavernous and supraclinoid portions). Agatston scores for right and left intracranial ICA and the combined total of right and left scores were calculated. The petrous portion of ICA was not assessed because of its close proximity to the bone limited the ability to draw a region of interest around calcifications without including the surrounding bone.


Intracranial Carotid Calcification on Cranial Computed Tomography: Visual Scoring Methods, Semiautomated Scores, and Volume Measurements in Patients With Stroke.

Subedi D, Zishan US, Chappell F, Gregoriades ML, Sudlow C, Sellar R, Wardlaw J - Stroke (2015)

A, Measurement of internal carotid artery (ICA) calcification by semiquantitative methods. A region of interest is drawn around the calcified artery in a wide window setting, from the petrous apex to the internal carotid bifurcation. B, Modified Woodcock visual calcium score. Data derived from Woodcock et al.16 Assessment done per side on each slice and then the slice scores are summed to give an overall calcium grade for each ICA.16
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4542564&req=5

Figure 1: A, Measurement of internal carotid artery (ICA) calcification by semiquantitative methods. A region of interest is drawn around the calcified artery in a wide window setting, from the petrous apex to the internal carotid bifurcation. B, Modified Woodcock visual calcium score. Data derived from Woodcock et al.16 Assessment done per side on each slice and then the slice scores are summed to give an overall calcium grade for each ICA.16
Mentions: To calculate Agatston score, the software identifies calcifications in the arteries within a region of interest (Figure 1A) in every slice as areas with density >130 HU. At least 3 contiguous pixels with HU>130 are registered as calcification. Area of each of these calcifications is multiplied by a cofactor, which depends on the peak density of the individual plaque (130–199 HU=1; 200–299 HU=2; 300–399 HU=3; and >400 HU=4). Thus, Agatston score is a measure of calcification weighted to a cofactor of peak density of individual plaques. Care was taken to draw the region of interest (Figure 1A) around carotid calcifications on bone window setting to exclude bone from the region of interest, and the readers were allowed to manipulate the window level and width to avoid contamination from adjacent bone. Each ICA was assessed from the petrous apex to the terminal bifurcation (cavernous and supraclinoid portions). Agatston scores for right and left intracranial ICA and the combined total of right and left scores were calculated. The petrous portion of ICA was not assessed because of its close proximity to the bone limited the ability to draw a region of interest around calcifications without including the surrounding bone.

Bottom Line: Intracranial internal carotid artery calcification increased with age by all measures (eg, visual score, Spearman ρ=0.4; P=0.005).Visual scores correlate highly with quantitative intracranial internal carotid artery calcification measures, with excellent observer agreements.Visual intracranial internal carotid artery scores could be a rapid and practical method for epidemiological studies.

View Article: PubMed Central - PubMed

Affiliation: From the Department of Clinical Radiology, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom (D.S., U.S.Z., M.-L.G.); Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom (F.C., C.S., R.S., J.W.); and Brain Research Imaging Centre, Scottish Imaging Network-A Platform for Scientific Excellence (SINAPSE) Collaboration, Edinburgh, United Kingdom (R.S., J.W.).

Show MeSH
Related in: MedlinePlus