Koos Ralf, Mahnken Andreas Horst, Kühl Harald Peter, Mühlenbruch Georg, Mevissen Vera, Stork Ludwig, Dronskowski Richard, Langebartels Georg, Autschbach Rüdiger, Ortlepp Jan R
Department of Cardiology, University Hospital RWTH Aachen, Germany.
Invest Radiol. 2006 May;41(5):485-9. doi: 10.1097/01.rli.0000208224.93467.87.
Multislice spiral computed tomography (MSCT) allows the in vivo detection of valvular calcification. The aim of this study was to validate the quantification of aortic valve calcification (AVC) by MSCT with in vitro measurements by atomic absorption spectroscopy.
In 18 patients with severe aortic stenosis, 16 detector row MSCT (SOMATOM Sensation 16, Siemens, Forchheim, Germany with scan parameters as follows: 420 milliseconds tube rotation time, 12 x 0.75 mm collimation, tube voltage 120 KV) was performed before aortic valve replacement. Images were reconstructed at 60% of the RR interval with an effective slice thickness of 3 mm and a reconstruction increment of 2 mm. AVC was assessed using Agatston AVC score, mass AVC score, and volumetric AVC score. After valve replacement, the calcium content of the excised human stenotic aortic valves was determined in vitro using atomic absorption spectroscopy.
The mean Agatston AVC score was 3,842 +/- 1,790, the mean volumetric AVC score was 3,061 +/- 1,406, and mass AVC score was 888 +/- 492 as quantified by MSCT. Atomic absorption spectroscopy showed a mean true calcification mass (Ca5(PO4)3OH) of 19 +/- 8 mass%. There was a significant correlation between in vivo AVC scores determined by MSCT and in vitro mean true calcification mass (r = 0.74, P = 0.0004 for mass AVC score, r = 0.79, P = 0.0001 for volumetric AVC score and r = 0.80, P = 0.0001 for Agatston AVC score) determined by atomic absorption spectroscopy. Linear regression analysis showed a significant association between the degree of hydroxyapatite (given in mass%) in the aortic valve and the degree of AVC (R = 0.74, F = 19.6, P = 0.0004 for mass AVC score, R = 0.80, F = 29.3, P = 0.0001 for Agatston AVC score and R = 0.79, F = 27.3, P = 0.0001 for volumetric AVC score) assessed by MSCT.
MSCT allows accurate in vivo quantification of aortic valve calcifications.
多层螺旋计算机断层扫描（MSCT）能够在体内检测瓣膜钙化。本研究的目的是通过原子吸收光谱法进行体外测量来验证MSCT对主动脉瓣钙化（AVC）的定量分析。
对18例重度主动脉瓣狭窄患者，在主动脉瓣置换术前进行16排探测器MSCT（西门子SOMATOM Sensation 16，德国福希海姆，扫描参数如下：管旋转时间420毫秒，准直12×0.75毫米，管电压120千伏）。在RR间期的60%进行图像重建，有效层厚3毫米，重建间隔2毫米。使用阿加斯顿AVC评分、质量AVC评分和容积AVC评分评估AVC。瓣膜置换术后，使用原子吸收光谱法在体外测定切除的人狭窄主动脉瓣的钙含量。
通过MSCT定量分析，平均阿加斯顿AVC评分为3842±1790，平均容积AVC评分为3061±1406，质量AVC评分为888±492。原子吸收光谱法显示平均真实钙化质量（Ca5(PO4)3OH）为19±8质量%。MSCT测定的体内AVC评分与原子吸收光谱法测定的体外平均真实钙化质量之间存在显著相关性（质量AVC评分：r = 0.74，P = 0.0004；容积AVC评分：r = 0.79，P = 0.0001；阿加斯顿AVC评分：r = 0.80，P = 0.0001）。线性回归分析显示主动脉瓣中羟基磷灰石的程度（以质量%表示）与MSCT评估的AVC程度之间存在显著关联（质量AVC评分：R = 0.74，F = 19.6，P = 0.0004；阿加斯顿AVC评分：R = 0.80，F = 29.3，P = 0.0001；容积AVC评分：R = 0.79，F = 27.3，P = 0.0001）。
MSCT能够在体内准确地对主动脉瓣钙化进行定量分析。
