Koos Ralf, Mahnken Andreas Horst, Sinha Anil Martin, Wildberger Joachim Ernst, Hoffmann Rainer, Kühl Harald Peter
Department of Cardiology, University Hospital Aachen, Pauwelsstrasse 30, Aachen 52072, Germany.
AJR Am J Roentgenol. 2004 Dec;183(6):1813-8. doi: 10.2214/ajr.183.6.01831813.
The degree of valvular calcification in patients with aortic stenosis was determined with retrospectively ECG-gated 16-MDCT and correlated with the severity of stenosis assessed at cardiac catheterization.
We conducted a prospective study of 72 patients (38 men and 34 women; mean age +/- SD, 69.5 +/- 8.8 years) with aortic stenosis who underwent 16-MDCT and cardiac catheterization. Aortic valve calcification was assessed using the aortic Agatston score, aortic mass score, and aortic volume score. Severity of aortic stenosis was classified at cardiac catheterization. Aortic valve area and peak-to-peak and mean transvalvular gradients were correlated with the degree of calcification determined on MDCT.
All measured aortic valve calcification scores were significantly higher in patients with severe aortic stenosis (n = 46) than in patients with moderate (n = 15) or mild (n = 11, p < 0.001) aortic stenosis. Aortic valve calcification scores were inversely related to aortic valve area (r = -0.67, p < 0.001 for aortic mass score) and correlated significantly with peak-to-peak (r = 0.70, p < 0.001) and mean transvalvular (r = 0.72, p < 0.001) gradients. No correlation between the aortic valve calcification and the total coronary calcium scores was observed.
Aortic valve calcification assessed on 16-MDCT is associated with severity of aortic stenosis. Thus, aortic valve calcification scores should be calculated routinely in all patients undergoing MDCT for assessment of coronary calcification. High aortic valve calcification scores indicate possibly severe aortic stenosis and should prompt a further functional evaluation.
采用回顾性心电图门控16层螺旋CT测定主动脉瓣狭窄患者的瓣膜钙化程度，并将其与心导管检查评估的狭窄严重程度进行关联分析。
我们对72例主动脉瓣狭窄患者（38例男性和34例女性；平均年龄±标准差，69.5±8.8岁）进行了一项前瞻性研究，这些患者均接受了16层螺旋CT和心导管检查。使用主动脉阿加斯顿积分、主动脉质量积分和主动脉容积积分评估主动脉瓣钙化情况。在心导管检查时对主动脉瓣狭窄的严重程度进行分类。将主动脉瓣面积、峰-峰压差和平均跨瓣压差与多层螺旋CT测定的钙化程度进行关联分析。
重度主动脉瓣狭窄患者（n = 46）的所有测量主动脉瓣钙化积分均显著高于中度（n = 15）或轻度（n = 11，p < 0.001）主动脉瓣狭窄患者。主动脉瓣钙化积分与主动脉瓣面积呈负相关（主动脉质量积分r = -0.67，p < 0.001），与峰-峰压差（r = 0.70，p < 0.001）和平均跨瓣压差（r = 0.72，p < 0.001）显著相关。未观察到主动脉瓣钙化与总冠状动脉钙化积分之间存在相关性。
16层螺旋CT评估的主动脉瓣钙化与主动脉瓣狭窄的严重程度相关。因此，对于所有接受多层螺旋CT检查以评估冠状动脉钙化的患者，应常规计算主动脉瓣钙化积分。主动脉瓣钙化积分高提示可能存在重度主动脉瓣狭窄，应促使进一步进行功能评估。
