[Clinical significance of coronary calcifications in electron beam tomography]

Electron-beam computed tomography (EBCT) permits high-resolution imaging of the beating heart and the coronary arteries and visualization of coronary calcification. For clinical purposes, coronary calcification represents the formation of atherosclerotic plaques. EBCT provides for accurate quantification of calcification, which is itself related to the extent of coronary atherosclerosis in a linear fashion. Accordingly, EBCT has been shown to measure the extent of coronary atherosclerosis. Importantly, an EBCT scan negative for calcification has a high negative predictive value indicating the absence of obstructive coronary artery disease and an excellent short- to midterm prognosis. It appears that, in general, the amounts of calcification detected by EBCT can be used for prospective risk stratification in symptomatic and asymptomatic adults. However, data derived from unbiased populations are not available at present, and the role of calcification in predicting acute coronary syndromes remains debated. Longitudinal EBCT examinations have emerged as another area of substantial clinical interest. The clinical value of this method remains to be defined, in particular, in comparison with competing, established modalities.