Review
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Nephrol. May 6, 2017; 6(3): 100-110
Published online May 6, 2017. doi: 10.5527/wjn.v6.i3.100
Role of different imaging modalities of vascular calcification in predicting outcomes in chronic kidney disease
Sinee Disthabanchong, Sarinya Boongird
Sinee Disthabanchong, Sarinya Boongird, Division of Nephrology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10310, Thailand
Author contributions: Disthabanchong S contributed 50% and Boongird S contributed 50% and to this review.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Sinee Disthabanchong, MD, Professor of Medicine, Division of Nephrology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama VI Rd, Bangkok 10310, Thailand. sineemd@hotmail.com
Telephone: +66-2-2011116 Fax: +66-2-2011400
Received: January 28, 2017
Peer-review started: February 8, 2017
First decision: March 7, 2017
Revised: March 27, 2017
Accepted: April 18, 2017
Article in press: April 19, 2017
Published online: May 6, 2017
Processing time: 95 Days and 18.6 Hours
Abstract

Vascular calcification (VC) is common among patients with chronic kidney disease (CKD). The severity of VC is associated with increased risk of cardiovascular events and mortality. Risk factors for VC include traditional cardiovascular risk factors as well as CKD-related risk factors such as increased calcium and phosphate load. VC is observed in arteries of all sizes from small arterioles to aorta, both in the intima and the media of arterial wall. Several imaging techniques have been utilized in the evaluation of the extent and the severity of VC. Plain radiographs are simple and readily available but with the limitation of decreased sensitivity and subjective and semi-quantitative quantification methods. Mammography, especially useful among women, offers a unique way to study breast arterial calcification, which is largely a medial-type calcification. Ultrasonography is suitable for calcification in superficial arteries. Analyses of wall thickness and lumen size are also possible. Computed tomography (CT) scan, the gold standard, is the most sensitive technique for evaluation of VC. CT scan of coronary artery calcification is not only useful for cardiovascular risk stratification but also offers an accurate and an objective analysis of the severity and progression.

Keywords: Coronary calcification; Aortic calcification; Hemodialysis; Dialysis; Ultrasound; Mammogram; Plain X-ray

Core tip: Vascular calcification (VC) is common among patients with chronic kidney disease. VC is observed in arteries of all sizes. Several imaging techniques have been utilized in the evaluation of VC. Plain radiographs are simple, readily available and can somewhat differentiate between intimal and medial calcification. Mammography detects medial calcification and is especially useful among women. Ultrasonography is suitable for superficial arteries. Analyses of wall thickness and lumen size are possible. Computed tomography, the gold standard, is the most sensitive technique and offers the most accurate analysis of the severity and progression of VC.