Analysis of calcium in carotid plaques with Agatston scores for appropriate selection of surgical intervention.

BACKGROUND AND PURPOSE The aim of the study was to determine whether the Agatston calcium score might be applied as a useful tool for evaluation of carotid stenosis. METHODS A total of 124 carotid bifurcations were examined with multidetector row CT. Calcium scores were determined according to the method described by Agatston et al. RESULTS Agatston scores generally appear appropriate for evaluation of calcified plaques. Calcified lesions with bigger differences between mean and peak Hounsfield unit (HU) in single cases accounted for only 34.3% of those with volume scores under 500 mm(3), whereas 81.3% (P<0.001) for those sized >500 mm(3). CONCLUSIONS The Agatston calcium score is useful in evaluating carotid plaques with calcium. We recommend, however, individual analyses for quality (hardness) and quantity (volume) of each large calcified focus (>500 mm(3)) by multidetector row CT lesions in order to provide indications for surgical treatment of carotid stenosis, carotid endarterectomy or carotid artery stenting.