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When you take a CT scan, what you see white in the area of your heart is lime. You can understand lime as a clump of calcium in our body that is attached to our blood vessels. An easy example is a hard shell attached to a blood vessel.
At first glance, a CT scan may appear to show that the calcification is completely blocking the blood vessel. But in fact, when you look at the calcification with coronary angiography, you can see that most of them are smaller than what you see on CT.
There are two reasons why the lime on CT looks larger than it actually is.
First, because of the x-rays used in CT scans. X-rays disperse light when it encounters a hard substance such as lime, and in the process, it takes a picture that is 2~3 times larger than the real thing. As a result, it actually appears as if a small piece of lime is blocking the entire blood vessel.
Second, because of the resolution of the CT scan. CT has a resolution of 0.6 mm. It may seem very detailed to draw a dot with a diameter of 0.6mm, but the problem is that the thickness of our blood vessels is about 3~4mm in diameter. If you take a 0.6 mm picture of a 3 mm blood vessel, even a slight mistake can result in a 20% error. The CT scan is set to look a little narrower to prevent missing the bottle. If a CT scan shows that the blood vessels are 60% narrower, it could actually be 40%.
Unlike CT, contrast imaging involves inserting a contrast agent into a tube, and it has a detailed resolution of about 0.1 mm. The CT scan showed a lot of narrowness, but that's why it's okay when you look at it with a contrast. This effect of large calcification on CT is called the Blooming Effect. This means that lime blooms like a flower and looks bigger.
The calcification index is not an index that indicates the narrowness of the blood vessels, but rather the presence of atherosclerosis or atherosclerosis around the coronary arteries. The higher the calcification index, the more likely it is that atherosclerosis is widespread.
The calcification index is calculated by multiplying the area of the calcification that appears when a CT scan is multiplied by the degree of intensity. People with a calcification index of 0 or no calcification at all can wait for 4~5 years, but a calcification index of 300 points or more is judged to cause many cardiac events such as death, myocardial infarction, and stroke. Of course, there is also arteriosclerosis that does not produce lime, so this is not an absolute figure.
If the blood vessels become oily and the inflammatory reaction continues for a long time, calcification develops. At the beginning of calcification, when thin clumps of calcium begin to form, there is a risk of blood clots or myocardial infarction, but as they age, the masses merge and stabilize. These calcifications are not in themselves the goal of treatment.
In fact, when hyperlipidemia or atherosclerosis is treated with statins, the results show that lime does not change, or even increases. This is because calcification is not a disease, but a scar left after arteriosclerosis and atherosclerosis are stabilized. You don't need to treat the scar caused by folliculitis, but you do need to treat folliculitis nearby.
Rising calcification levels are generally not a concern. The calcification index naturally rises every year, and arteriosclerosis stabilizes. If the calcification index is less than 100 points, it is enough to inspect it after 5~10 years, and if it is 100~400 points, it is enough to inspect it after 3 years. However, if there are symptoms of angina pectoris in addition to a high calcification index, additional tests should be actively performed.
Calcifications are scars that indicate the presence of atherosclerosis or arteriosclerosis. Calcifications do not mean that the blood vessels are narrow, and those with risk factors such as diabetes or high blood pressure can consider it as a sign that they should actively treat hyperlipidemia if they have calcifications.
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