CT Calcium Scoring

Computed tomography (CT) calcium scoring uses special x-ray equipment to acquire images of the coronary arteries to determine if they are blocked or narrowed by the buildup of plaque – an indicator for atherosclerosis or coronary artery disease (CAD). The information obtained can help evaluate whether you are at increased risk for heart attack.

What is Cardiac CT Calcium Scoring?

Computed tomography, more commonly known as a CT or CAT scan, is a diagnostic medical imaging test. Like traditional x-rays, it produces multiple images or pictures of the inside of the body.

The cross-sectional images generated during a CT scan can be reformatted in multiple planes. They can even generate three-dimensional images. These images can be viewed on a computer monitor, printed on film or by a 3D printer, or transferred to a CD or DVD.

CT images of internal organs, bones, soft tissue and blood vessels provide greater detail than traditional x-rays, particularly of soft tissues and blood vessels.

A cardiac CT scan for coronary calcium is a non-invasive way of obtaining information about the presence, location and extent of calcified plaque in the coronary arteries—the vessels that supply oxygen-containing blood to the heart muscle. Calcified plaque results when there is a build-up of fat and other substances under the inner layer of the artery. This material can calcify which signals the presence of atherosclerosis, a disease of the vessel wall, also called coronary artery disease (CAD). People with this disease have an increased risk for heart attacks. In addition, over time, progression of plaque build up (CAD) can narrow the arteries or even close off blood flow to the heart. The result may be chest pain, sometimes called “angina,” or a heart attack.

Because calcium is a marker of CAD, the amount of calcium detected on a cardiac CT scan is a helpful prognostic tool. The findings on cardiac CT are expressed as a calcium score. Another name for this test is coronary artery calcium scoring.

Who should get this procedure?

The goal of cardiac CT calcium scoring is to determine if CAD is present and to what extent, even if there are no symptoms. It is a screening study that may be recommended by a physician for patients with risk factors for CAD but no clinical symptoms.

Major risk factors for CAD are:

  • high blood cholesterol levels
  • family history of heart attacks
  • diabetes
  • high blood pressure
  • cigarette smoking
  • overweight or obese
  • physical inactivity

Your CT calcium scoring results

The extent of CAD is graded according to you calcium score:

Calcium Score Presence of CAD
0 No evidence of CAD
1-10 Minimal evidence of CAD
11-100 Mild evidence of CAD
101-400 Moderate evidence of CAD
Over 401 Extensive evidence of CAD

What are the benefits vs. risks?

Benefits:

  • Cardiac CT for calcium scoring is a convenient and noninvasive way of evaluating whether you may be at increased risk for a heart attack.
  • The exam takes little time, causes no pain, and does not require injection of contrast material.
  • An EBCT scan takes less than 20 minutes and you can return to normal activities immediately afterward.
  • No radiation remains in a patient’s body after a CT examination.
  • X-rays used in CT scans should have no immediate side effects.

Risks:

  • There is always a slight chance of cancer from excessive exposure to radiation. However, the benefit of an accurate diagnosis far outweighs the risk.
  • Women should always tell their doctor and x-ray or CT technologist if there is any chance they are pregnant.
  • CT scanning is, in general, not recommended for pregnant women unless medically necessary because of potential risk to the unborn baby.
  • A high calcium score may sometimes be followed by other diagnostic tests for heart disease, which may or may not provide results with clinical value and can be associated with side effects.