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Atherosclerotic Calcification Detection: A Comparative Study of Carotid Ultrasound and Cone Beam CT

Department of Public Health and Clinical Medicine, Umeå University, 90187 Umeå, Sweden
Department of Pharmacology and Clinical Neuroscience, Umeå University, 90187 Umeå, Sweden
Department of Odontology, Umeå University, 90187 Umeå, Sweden
Department of Surgical and Perioperative Sciences, Umeå University, 90187 Umeå, Sweden
Author to whom correspondence should be addressed.
Academic Editor: Kurt A. Jellinger
Int. J. Mol. Sci. 2015, 16(8), 19978-19988;
Received: 30 June 2015 / Revised: 7 August 2015 / Accepted: 13 August 2015 / Published: 21 August 2015
(This article belongs to the Special Issue Atherosclerosis and Vascular Imaging)
PDF [899 KB, uploaded 21 August 2015]


Background and Aim: Arterial calcification is often detected on ultrasound examination but its diagnostic accuracy is not well validated. The aim of this study was to determine the accuracy of carotid ultrasound B mode findings in detecting atherosclerotic calcification quantified by cone beam computed tomography (CBCT). Methods: We analyzed 94 carotid arteries, from 88 patients (mean age 70 ± 7 years, 33% females), who underwent pre-endarterectomy ultrasound examination. Plaques with high echogenic nodules and posterior shadowing were considered calcified. After surgery, the excised plaques were examined using CBCT, from which the calcification volume (mm3) was calculated. In cases with multiple calcifications the largest calcification nodule volume was used to represent the plaque. Carotid artery calcification by the two imaging techniques was compared using conventional correlations. Results: Carotid ultrasound was highly accurate in detecting the presence of calcification; with a sensitivity of 88.2%. Based on the quartile ranges of calcification volumes measured by CBCT we have divided plaque calcification into four groups: <8; 8–35; 36–70 and >70 mm3. Calcification volumes ≥8 were accurately detectable by ultrasound with a sensitivity of 96%. Of the 21 plaques with <8 mm3 calcification volume; only 13 were detected by ultrasound; resulting in a sensitivity of 62%. There was no difference in the volume of calcification between symptomatic and asymptomatic patients. Conclusion: Carotid ultrasound is highly accurate in detecting the presence of calcified atherosclerotic lesions of volume ≥8 mm3; but less accurate in detecting smaller volume calcified plaques. Further development of ultrasound techniques should allow better detection of early arterial calcification. View Full-Text
Keywords: carotid atherosclerosis; ultrasound; calcification carotid atherosclerosis; ultrasound; calcification

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Jashari, F.; Ibrahimi, P.; Johansson, E.; Ahlqvist, J.; Arnerlöv, C.; Garoff, M.; Jäghagen, E.L.; Wester, P.; Henein, M.Y. Atherosclerotic Calcification Detection: A Comparative Study of Carotid Ultrasound and Cone Beam CT. Int. J. Mol. Sci. 2015, 16, 19978-19988.

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