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Related Experiment Video

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Calcification of Vascular Smooth Muscle Cells and Imaging of Aortic Calcification and Inflammation
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Thoracic Aortic Calcification: Diagnostic, Prognostic, and Management Considerations.

Milind Y Desai1, Paul C Cremer1, Paul Schoenhagen2

  • 1Department of Cardiovascular Imaging, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio.

JACC. Cardiovascular Imaging
|July 7, 2018
PubMed
Summary

Thoracic aortic calcification (TAC) is linked to poor cardiovascular health. This review examines TAC in imaging, distinguishing its patterns in atherosclerosis versus other conditions, and its clinical impact.

Keywords:
computed tomographyechocardiographythoracic aortic calcification

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Area of Science:

  • Cardiovascular Imaging
  • Radiology
  • Atherosclerosis Research

Background:

  • Thoracic aortic calcification (TAC) is a common finding in cardiovascular imaging.
  • TAC is associated with adverse cardiovascular outcomes.
  • Understanding TAC's patterns is crucial for cardiovascular risk assessment.

Purpose of the Study:

  • This review focuses on thoracic aortic calcification (TAC) encountered in four primary clinical settings.
  • It aims to differentiate patterns of TAC in atherosclerosis versus other conditions.
  • The review evaluates the clinical significance of TAC in incidental findings, screening, embolic event evaluation, and procedural planning.

Main Methods:

  • Review of existing literature on thoracic aortic calcification.
  • Analysis of TAC patterns in different etiological contexts (atherosclerosis, metabolic disorders, aortitis, radiation-associated disease).
  • Evaluation of the clinical utility of TAC in specific imaging scenarios.

Main Results:

  • Atherosclerotic TAC originates in the intima with patchy distribution.
  • Metabolic disorders, aortitis, and radiation-associated disease show medial calcification, often concentric.
  • Incidental atherosclerotic TAC has limited discriminative value; screening is not currently supported.
  • TAC after embolic events offers diagnostic clarity but limited treatment implications.
  • Discovery of severe TAC (porcelain aorta) can alter procedural plans.

Conclusions:

  • Thoracic aortic calcification presents differently based on its underlying cause.
  • While TAC can provide diagnostic information, its role in screening and treatment guidance varies.
  • Awareness of TAC's varied presentations and implications is essential for cardiovascular imagers.