CT calcium scoring results explained by a radiologist

ARA’s Dr. Robert Lieberman explains the results of a CT calcium scoring to a patient. Known as the “heart saver,” this screening exam can detect calcium buildup in the heart, which indicates the presence of plaque in the coronary arteries. This condition is know as coronary artery disease, or CAD, and can go unnoticed until a major coronary event like a heart attack causes severe damage or even death. CT calcium scoring can find plaque so a treatment plan can be developed.

Also see our description of the exam at CT Calcium Scoring.

Transcript

Julia: Hey this is Julia Austin. I’m here with ARA Diagnostic Imaging and last week I had a CT calcium scoring here. This week I’m going to talk to Dr. Robert Lieberman who is an interventional radiologist with ARA and he’s going to help me understand what my score is and what that means, and we’re even going to get to look at the inside of my heart and see what it looks like. So, let’s see what it is. Dr. Lieberman?

Dr. Lieberman: Yeah, this is great. So last week we spoke about getting one of these and now we can actually see these live – what it looks like. We mentioned that you get an actual score from the exam. You get these results and then you get an interpretation to help guide the next step in management. You get all this with the package. The other great thing is you get the images themselves so we can actually look at the images and kind of figure out where the scoring comes from but the bonus here is that we give an actual CT image of part of the chest and there’s a lot more anatomy than just the heart.

Julia: So, that’s really cool. You can not only look at the heart but apparently the other areas of the chest.

Dr. L: Exactly, and that’s kind of why this is a great exam because even though we’re looking at the heart we pick up other diseases sometimes which can also help guide you in management in other fields like GI or bone or breast or other areas of the body. So, it’s great. So, we’ll start over here on this image here. You can actually see the images of the coronary arteries and we spoke about these last week. And down here is the actual score that the computer is able to generate based on the actual calcification. Your score is provided right here, 46. That’s actually a pretty good score but it means there’s still something going on which is the whole point of this exam.

Julia: Right!

Dr. L: You might think you’re completely healthy but there are early signs of disease and maybe it’s time to take that next step in management.

Julia: Right, okay!

Dr. L: The cool thing is yours pops out really well, so as you scroll throughout this area …

Julia: Wow, so that’s where my plaque is.

Dr. L: Exactly. And that plaque is very suspicious for an area of stenosis or an area of disease that we might want to get ahead of. And, this happens to be a branch of the left coronary artery and that is a very common area for heart disease to show up and it’s also an area that can become symptomatic and problematic down the line.

Julia: So, while I’m not, you don’t need to rush me to the hospital, it might be time for me to look at some management.

Dr. L: Exactly. Exactly. It’s all about patient awareness. Now that you’re aware that you’re at risk down the line you can take steps now. Whether diet management or perhaps see a physician about getting on a medication.

Julia: Yeah, well, yes. And I will because, you know, that’s why I got the exam, because I really wanted to know if I had this hereditary disease that my parents had and I have somewhat high cholesterol so I needed to know. Now I do. I’m very happy. Very nice to know. Not totally, you know, delighted that I have this but it’s better to know and better to be able to take care of yourself.

Dr. L: Exactly. And the good thing is, you don’t just get this score, you know, but it is a screening exam so it kind of it breaks you down into where you fall in the in the general population so yours is right here in the middle so there’s mild plaque burden and as you were mentioning there’s already some likely some disease there. We call it coronary stenosis. What that really means is that plaque might be causing a problem but it’s still in the early stages.

Julia: So, stenosis is kind of another word for hardening, right?

Dr. L: Yeah, that hardening can kind of slowly block that artery and as it becomes more and more blocked, we call that stenosis.

Julia: Okay.

Dr. L: So, it’s blocking the blood flow into the heart itself, making it harder and harder for the heart to pump as that blockage gets worse and worse. So, you want to catch it when it’s in the early stages.

Julia: And I did!

Dr. L: So, the good thing, is there’s other anatomy going on in the chest.

Julia: Yeah, let’s see that.

Dr. L: So, the heart isn’t the only thing that we’re scanning here. There’s also lung tissue, there’s esophagus, there’s bones. So as I scroll through here, this is the heart in the middle and other than this one area of plaque that I’ve highlighted there’s actually not a lot of white plaque – white looking like the bone here, that calcification, looking for the same thing and we don’t see a lot so that’s good. Which is why you actually have a pretty good score – mild stenosis.

Julia: Right.

Dr. L: The other areas of disease – we can look at both lungs, the visualized parts here, and there we might be looking for, you know, whether there’s emphysema from smoking or possibly nodules or cancer or even a pneumonia, with the current epidemic, with the coronavirus we definitely see stuff going on in the lungs.

Julia: Yeah, that’s really how you find pneumonia, right?

Dr. L: Exactly. Yeah, we get to, you know, screen for that as well on this exam.

Julia: Yeah.

Dr. L: Other areas – we see some bones and then the esophagus. A lot of people in the United States suffer from gastroesophageal reflux disease from, you know, diet-related mostly.

Julia: And you can see that, huh?

Dr. L: You can see that sometimes – see evidence of that on here and you can suggest taking the next steps there as well.

Julia: Well I did pretty good then.

Dr. L: Yeah really there’s a lot of potential things that could be going wrong here and you’re looking really good. That’s really good news.

Julia: Well, that’s good. Good news, bad news. That’s okay. So, I’m glad I got this. I’m glad to know what’s going on. Just want to say that this is a CT calcium scoring. I’m 59 years old. I got it because I have calcium and plaque buildup in my family history and I also have a high cholesterol score. So, I was curious and, indeed, this was a great exam for me. It’s not the thing for everyone but if you’re kind of in that category, talk to your doctor. I’m going to talk to my doctor about this exam and we will probably work out a plan, either dietary or maybe medication. Still haven’t thought that far ahead, but I just recommend it for certain people. So, talk to your doc and you can get it at ARA Diagnostic Imaging. It’s 75 dollars with or without insurance, so it’s a just the same for everyone and I think that it’s just a really good exam.

Thanks so much for being here. If you’d like to make an appointment, call us at (512) 453-6100 or go online. And that’s ausrad.com. Thanks so much and thanks to Dr. Lieberman.

Dr. L: Thank you.

Julia: All right, bye-bye!