Severe aortic arch calcification depicted on chest radiography strongly suggests coronary artery calcification
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Severe aortic arch calcification depicted on chest radiography strongly suggests coronary artery calcification. / Bannas, Peter; Jung, Caroline; Blanke, Philipp; Treszl, András; Derlin, Thorsten; Adam, Gerhard; Bley, Thorsten A.
in: EUR RADIOL, Jahrgang 23, Nr. 10, 01.10.2013, S. 2652-7.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Severe aortic arch calcification depicted on chest radiography strongly suggests coronary artery calcification
AU - Bannas, Peter
AU - Jung, Caroline
AU - Blanke, Philipp
AU - Treszl, András
AU - Derlin, Thorsten
AU - Adam, Gerhard
AU - Bley, Thorsten A
PY - 2013/10/1
Y1 - 2013/10/1
N2 - OBJECTIVE: To evaluate the association between aortic arch calcifications (AAC) on chest radiography and coronary artery calcium (CAC) score determined by CT.METHODS: A total of 128 patients (75 men; 69.3 ± 14.7 years) who underwent chest radiography and CAC scoring at CT were included in this retrospective analysis. The extent of AAC on chest radiography was evaluated independently by two blinded observers using a semi-quantitative four-point scale (0-3). Intra- and interobserver agreement was assessed by weighted ĸ statistics. Amount of AAC determined on radiography was correlated with CAC and ROC analyses performed to characterise the diagnostic performance of AAC grading.RESULTS: Excellent intraobserver (ĸ = 0.82) and good interobserver (ĸ = 0.75) agreement of AAC grading was noted. Moderate agreement (ĸ = 0.46, 95 % CI 0.36-0.56) with a linear trend (P < 0.0001) between AAC grades and CAC scores was found. Cut-off between AAC grades 0-2 and 3 had a sensitivity of 38.6 %, specificity of 96.4 %, PPV of 85.0 %, NPV of 75.0 % and accuracy of 76.6 % for the correct identification of CAC scores greater than 400.CONCLUSION: Semi-quantitative AAC grading on chest radiography is reliable and positively associated with CAC scoring. We propose to report the extent of AAC in comprehensive radiological reports as "not present", "moderate" or "severe", as severe AAC strongly suggests coronary artery calcification.KEY POINTS: • Semi-quantitative aortic arch calcification (AAC) grading on plain chest radiography appears reliable. • AAC grading is positively associated with CT coronary artery calcium scoring. • AAC grading has a high specificity for ruling out CAC scores greater than 400. • We propose the reporting of the extent of AAC grade in chest X-ray (CXR) reports.
AB - OBJECTIVE: To evaluate the association between aortic arch calcifications (AAC) on chest radiography and coronary artery calcium (CAC) score determined by CT.METHODS: A total of 128 patients (75 men; 69.3 ± 14.7 years) who underwent chest radiography and CAC scoring at CT were included in this retrospective analysis. The extent of AAC on chest radiography was evaluated independently by two blinded observers using a semi-quantitative four-point scale (0-3). Intra- and interobserver agreement was assessed by weighted ĸ statistics. Amount of AAC determined on radiography was correlated with CAC and ROC analyses performed to characterise the diagnostic performance of AAC grading.RESULTS: Excellent intraobserver (ĸ = 0.82) and good interobserver (ĸ = 0.75) agreement of AAC grading was noted. Moderate agreement (ĸ = 0.46, 95 % CI 0.36-0.56) with a linear trend (P < 0.0001) between AAC grades and CAC scores was found. Cut-off between AAC grades 0-2 and 3 had a sensitivity of 38.6 %, specificity of 96.4 %, PPV of 85.0 %, NPV of 75.0 % and accuracy of 76.6 % for the correct identification of CAC scores greater than 400.CONCLUSION: Semi-quantitative AAC grading on chest radiography is reliable and positively associated with CAC scoring. We propose to report the extent of AAC in comprehensive radiological reports as "not present", "moderate" or "severe", as severe AAC strongly suggests coronary artery calcification.KEY POINTS: • Semi-quantitative aortic arch calcification (AAC) grading on plain chest radiography appears reliable. • AAC grading is positively associated with CT coronary artery calcium scoring. • AAC grading has a high specificity for ruling out CAC scores greater than 400. • We propose the reporting of the extent of AAC grade in chest X-ray (CXR) reports.
KW - Aged
KW - Aorta, Thoracic
KW - Aortic Diseases
KW - Calcinosis
KW - Comorbidity
KW - Coronary Angiography
KW - Coronary Artery Disease
KW - Female
KW - Germany
KW - Humans
KW - Male
KW - Prevalence
KW - Radiography, Thoracic
KW - Reproducibility of Results
KW - Risk Factors
KW - Sensitivity and Specificity
U2 - 10.1007/s00330-013-2877-z
DO - 10.1007/s00330-013-2877-z
M3 - SCORING: Journal article
C2 - 23660774
VL - 23
SP - 2652
EP - 2657
JO - EUR RADIOL
JF - EUR RADIOL
SN - 0938-7994
IS - 10
ER -