64 排多层 CT 偶然检测到的二尖瓣钙化与超声心动图二尖瓣病变的关系。
Relationship between incidentally detected calcification of the mitral valve on 64-row multidetector computed tomography and mitral valve disease on echocardiography.
机构信息
Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
出版信息
Int J Gen Med. 2012;5:839-43. doi: 10.2147/IJGM.S33665. Epub 2012 Oct 10.
BACKGROUND
Mitral valve calcification is often incidentally detected on chest computed tomography (CT) scans obtained for a variety of noncardiac indications. In this study, we evaluated the association between mitral valve calcification incidentally detected on chest CT and the presence and severity of mitral valve disease on echocardiography.
METHODS
Of 760 patients undergoing 64-row multidetector CT of the chest, 50 with mitral valve calcification and 100 controls were referred on for echocardiography. Calcifications of the mitral valve leaflet and annulus were assessed for length, Agatston score, and site, and were compared with echocardiographic findings.
RESULTS
Mitral valve calcification was noted in 59 (7.7%) patients on multidetector CT. Fifty of these patients were assessed by echocardiography, and 32 (64%) were found to have mitral annular calcification. Nine patients (18%) had posterior mitral valve leaflet calcification, and both mitral valve leaflet and annular calcification were detected in nine (18%) cases. Nine (18%) patients had mild, three (6%) had moderate, and one (2%) had severe mitral stenosis. None of the patients with isolated mitral annular calcification had mitral stenosis; however, all the patients with mitral stenosis showed mitral valve leaflet calcification with or without mitral annular calcification (P < 0.001). Moreover, patients with mitral stenosis had a larger mitral calcification length and greater Agatston scores in comparison with those without mitral stenosis (P = 0.001). While 31 patients (62%) with mitral calcification had mitral regurgitation on echocardiography, 21 (21%) in the control group showed mitral regurgitation (P = 0.001).
CONCLUSION
Mitral valve leaflet calcification, with or without annular calcification, may be an indicator of mitral stenosis. Mitral calcification can also be considered as an indicator for mitral regurgitation in general. Therefore, patients with mitral valve calcification detected incidentally on chest CT scan may benefit from functional assessment of the valve using echocardiography.
背景
在因各种非心脏原因进行的胸部 CT 扫描中，常偶然发现二尖瓣钙化。在这项研究中，我们评估了胸部 CT 偶然发现的二尖瓣钙化与超声心动图上二尖瓣疾病的存在和严重程度之间的关系。
方法
在 760 例行 64 排多层 CT 胸部检查的患者中，50 例存在二尖瓣钙化，100 例为对照组，均接受超声心动图检查。评估二尖瓣瓣叶和瓣环的钙化长度、Agatston 评分和部位，并与超声心动图结果进行比较。
结果
59 例（7.7%）患者在多排 CT 上发现二尖瓣钙化。其中 50 例接受超声心动图检查，32 例（64%）发现二尖瓣环钙化。9 例（18%）存在后瓣叶钙化，9 例（18%）存在瓣叶和瓣环钙化。9 例（18%）患者为轻度二尖瓣狭窄，3 例（6%）为中度二尖瓣狭窄，1 例（2%）为重度二尖瓣狭窄。单纯二尖瓣环钙化患者无一例有二尖瓣狭窄；然而，所有有二尖瓣狭窄的患者均有二尖瓣叶钙化，伴或不伴二尖瓣环钙化（P<0.001）。此外，有二尖瓣狭窄的患者的二尖瓣钙化长度和 Agatston 评分均大于无二尖瓣狭窄的患者（P=0.001）。在 31 例（62%）有二尖瓣钙化的患者中，超声心动图显示二尖瓣反流，而对照组中有 21 例（21%）有二尖瓣反流（P=0.001）。
结论
瓣叶钙化，伴或不伴瓣环钙化，可能是二尖瓣狭窄的一个指标。一般来说，二尖瓣钙化也可以作为二尖瓣反流的一个指标。因此，胸部 CT 偶然发现二尖瓣钙化的患者可能受益于超声心动图对瓣膜功能的评估。
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