What is the role of electron-beam CT (EBCT) in the detection of coronary artery calcification?

Answer

The initial investigation of coronary artery calcification with CT was made possible with the development of the electron-beam CT (EBCT) scanner in the late 1980s. The speed of this machine was vastly superior to that of existing CT scanners. With this speed, it had the ability to "stop" heart motion enough to allow measurement of the amount of calcium in a coronary artery. Another revolution in CT has was the development of ultrafast spiral CT.^{[10, 11]}

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Media Gallery

Coronary artery calcification - CT. Cross-sectional image obtained through the heart at the level of the left anterior descending (LAD) artery. The protocol on the CT machine colors all structures with an attenuation of greater than 130 HU pink. No calcium (pink) is present in the LAD or diagonal branch.
Coronary artery calcification - CT. Image obtained in a patient with a large amount of calcium in the left anterior descending (LAD) artery. Note that other hyperattenuating structures (eg, bone, calcified lymph nodes) are pink. During the scoring process, the radiologist must circle only those areas that correspond to one of the coronary arteries.
Coronary artery calcification - CT. Image obtained without the threshold set to color the calcium pink. Note the large amount of calcium in the left anterior descending (LAD) and left circumflex arteries.
Coronary artery calcification - CT. Section caudal to that in the previous image shows calcium in the left anterior descending (LAD) artery as it courses down the front of the heart. The vessel is now depicted in cross section.
Helical non–contrast-enhanced CT reveals calcification involving the left main coronary artery.

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Author

J Bayne Selby, Jr, MD Professor of Radiology, Co-Director, Division of Interventional Radiology, Department of Radiology, Medical University of South Carolina

J Bayne Selby, Jr, MD is a member of the following medical societies: Radiological Society of North America, South Carolina Medical Association

Disclosure: Nothing to disclose.

Coauthor(s)

Pamela Bowe Morris, MD, FACC, FACP, FACPM Assistant Professor of Medicine, Consulting Staff, Director of Preventive Cardiology, Co-Director of Women's Heart Care, Medical University of South Carolina; Consulting Staff, Department of Internal Medicine and Cardiology, Roper Hospital; Medical Director, FitHeart Cardiovascular Disease Prevention Program

Pamela Bowe Morris, MD, FACC, FACP, FACPM is a member of the following medical societies: American College of Cardiology, American College of Physicians-American Society of Internal Medicine, American College of Preventive Medicine, American Heart Association, Phi Beta Kappa, National Lipid Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Bernard D Coombs, MB, ChB, PhD Consulting Staff, Department of Specialist Rehabilitation Services, Hutt Valley District Health Board, New Zealand

Disclosure: Nothing to disclose.

Chief Editor

Eugene C Lin, MD Attending Radiologist, Teaching Coordinator for Cardiac Imaging, Radiology Residency Program, Virginia Mason Medical Center; Clinical Assistant Professor of Radiology, University of Washington School of Medicine

Eugene C Lin, MD is a member of the following medical societies: American College of Nuclear Medicine, American College of Radiology, Radiological Society of North America, Society of Nuclear Medicine and Molecular Imaging

Disclosure: Nothing to disclose.

Additional Contributors

Justin D Pearlman, MD, ME, PhD, FACC, MA Chief, Division of Cardiology, Director of Cardiology Consultative Service, Director of Cardiology Clinic Service, Director of Cardiology Non-Invasive Laboratory, Chair of Institutional Review Board, University of California, Los Angeles, David Geffen School of Medicine

Justin D Pearlman, MD, ME, PhD, FACC, MA is a member of the following medical societies: American College of Cardiology, International Society for Magnetic Resonance in Medicine, American College of Physicians, American Federation for Medical Research, Radiological Society of North America

Disclosure: Nothing to disclose.

Acknowledgements

The authors and editors of eMedicine gratefully acknowledge the contributions of Michael Assey, MD, to the development and writing of this article.

What is the role of electron-beam CT (EBCT) in the detection of coronary artery calcification?

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