Mahnken Andreas H, Mühlenbruch Georg, Das Marco, Wildberger Joachim E, Kühl Harald P, Günther Rolf W, Kelm Malte, Koos Ralf
Department of Diagnostic Radiology, University Hospital, RWTH-Aachen University, Pauwelsstrasse 30, D-52074 Aachen, Germany.
AJR Am J Roentgenol. 2007 May;188(5):1264-9. doi: 10.2214/AJR.06.1002.
The purpose of this study was to analyze the prevalence and clinical significance of mitral valve calcification incidentally detected on chest CT scans in comparison with echocardiography.
The data of 390 patients (227 men and 163 women; mean age, 62.4 +/- 12.2 years) who underwent MDCT of the chest and echocardiography were retrospectively evaluated. On MDCT, mitral valve leaflet and annulus calcification were visually graded on a scale of 0-3, with grade 0 denoting no calcification and grade 3 indicating severe calcification. CT findings were correlated with hemodynamic data obtained at echocardiography. Unpaired Student's t tests, chi-square analysis, and a weighted-kappa test were used to compare results.
In 32 (8.2%) of 390 patients, chest MDCT revealed mitral valve leaflet calcification. Fifteen of these patients (15/390, 3.8%) presented with mitral valve stenosis. Excellent agreement (kappa = 0.882) was seen between the presence of mitral valve calcification on MDCT and echocardiographically proven mitral valve sclerosis. Mitral valve leaflet calcification on MDCT and the severity of mitral valve disease on echocardiography showed a substantial agreement (kappa = 0.730). A significant relationship was seen between the degree of mitral valve calcification on MDCT and the echocardiographically determined severity of mitral valve disease (no sclerosis vs mitral sclerosis vs mitral stenosis; p < 0.0001).
Mitral valve leaflet calcification on MDCT indicates mitral valve sclerosis or stenosis. Thus, patients presenting with incidentally detected mitral valve leaflet calcification on chest CT may benefit from a functional assessment with echocardiography.
本研究旨在分析胸部CT扫描偶然发现的二尖瓣钙化的患病率及其临床意义，并与超声心动图进行比较。
回顾性评估390例行胸部MDCT及超声心动图检查的患者（227例男性和163例女性；平均年龄62.4±12.2岁）的数据。在MDCT上，二尖瓣叶和瓣环钙化采用0-3级视觉分级，0级表示无钙化，3级表示重度钙化。CT检查结果与超声心动图获得的血流动力学数据相关。采用非配对t检验、卡方分析和加权kappa检验比较结果。
390例患者中，32例（8.2%）胸部MDCT显示二尖瓣叶钙化。其中15例患者（15/390，3.8%）存在二尖瓣狭窄。MDCT上二尖瓣钙化的存在与超声心动图证实的二尖瓣硬化之间存在高度一致性（kappa=0.882）。MDCT上二尖瓣叶钙化与超声心动图显示的二尖瓣疾病严重程度之间存在实质性一致性（kappa=0.730）。MDCT上二尖瓣钙化程度与超声心动图确定的二尖瓣疾病严重程度之间存在显著相关性（无硬化vs二尖瓣硬化vs二尖瓣狭窄；p<0.0001）。
MDCT上二尖瓣叶钙化提示二尖瓣硬化或狭窄。因此，胸部CT偶然发现二尖瓣叶钙化的患者可能受益于超声心动图的功能评估。
