Koos Ralf, Kühl Harald Peter, Mühlenbruch Georg, Wildberger Joachim Ernst, Günther Rolf W, Mahnken Andreas Horst
Departments of Cardiology and Diagnostic Radiology, University Hospital Aachen, University of Technology Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany.
Radiology. 2006 Oct;241(1):76-82. doi: 10.1148/radiol.2411051163. Epub 2006 Aug 14.
To evaluate retrospectively the prevalence and grade of aortic valve calcification incidentally detected on chest multi-detector row computed tomographic (CT) scans and to compare the grade of calcification with the severity of aortic valve disease as assessed with echocardiography.
Patient informed consent was waived by the institutional board on medical ethics that approved this study. The authors identified 402 patients (231 men and 171 women; mean age, 62.5 years +/- 12.1) of 1820 patients who underwent chest multi-detector row CT between July 2001 and August 2004 and also underwent echocardiography. Aortic valve calcification at multi-detector row CT was visually graded on a scale ranging from 0 to 4 (0 = no calcification, 4 = severe calcification). CT findings were correlated with hemodynamic data obtained at echocardiography. Patients without aortic stenosis were compared with patients with aortic stenosis. The Student t test, Spearman correlation coefficient, chi(2) analysis, and an unweighted kappa test were used to compare results.
Aortic valve calcification was noted on multi-detector row CT scans in 72 of the 402 patients (18%). Twelve of 20 patients (60%) with grade 3 or grade 4 calcification on CT scans had aortic stenosis at echocardiography, compared with only nine of 382 patients (2.4%) with grade 0-2 calcification (P < .001). Significant correlations were observed between the grade of aortic valve calcification and the echocardiographically determined mean (r = 0.45, P = .03) and peak transvalvular gradient (r = 0.47, P = .03). There was substantial agreement between the grade of valve calcification at multi-detector row CT and the severity of aortic valve disease at echocardiography (kappa = 0.67).
Aortic valve calcification was an incidental finding on 18% of multi-detector row CT scans. The grade of aortic valve calcification is correlated with the hemodynamic severity of aortic valve disease as determined with echocardiography.
回顾性评估胸部多排螺旋计算机断层扫描（CT）偶然发现的主动脉瓣钙化的发生率和分级，并将钙化分级与经超声心动图评估的主动脉瓣疾病严重程度进行比较。
本研究获机构医学伦理委员会批准，患者知情同意书被豁免。作者从2001年7月至2004年8月期间接受胸部多排螺旋CT检查且同时接受超声心动图检查的1820例患者中，确定了402例患者（231例男性和171例女性；平均年龄62.5岁±12.1岁）。多排螺旋CT上的主动脉瓣钙化通过视觉分级，范围为0至4级（0 =无钙化，4 =重度钙化）。CT检查结果与超声心动图获得的血流动力学数据相关。将无主动脉瓣狭窄的患者与有主动脉瓣狭窄的患者进行比较。采用Student t检验、Spearman相关系数、chi(2)分析和非加权kappa检验来比较结果。
402例患者中有72例（18%）在多排螺旋CT扫描中发现主动脉瓣钙化。CT扫描钙化分级为≥3级的20例患者中有12例（60%）超声心动图显示有主动脉瓣狭窄，而钙化分级为0 - 2级的382例患者中只有9例（2.4%）有主动脉瓣狭窄（P <.001）。主动脉瓣钙化分级与超声心动图测定的平均跨瓣压差（r = 0.45，P =.03）和峰值跨瓣压差（r = 0.47，P =.03）之间存在显著相关性。多排螺旋CT上的瓣膜钙化分级与超声心动图上的主动脉瓣疾病严重程度之间存在高度一致性（kappa = 0.67）。
18%的多排螺旋CT扫描偶然发现主动脉瓣钙化。主动脉瓣钙化分级与经超声心动图确定的主动脉瓣疾病血流动力学严重程度相关。
