title: Prevalence and clinical importance of aortic valve calcification detected incidentally on CT scans: comparison with echocardiography.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Departments of Cardiology and Diagnostic Radiology, University Hospital Aachen, University of Technology Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany. rkoos@ukaachen.de
authors.forename: Ralf
authors.initials: R
authors.lastname: Koos
authors.forename: Harald Peter
authors.initials: HP
authors.lastname: Kühl
authors.forename: Georg
authors.initials: G
authors.lastname: Mühlenbruch
authors.forename: Joachim Ernst
authors.initials: JE
authors.lastname: Wildberger
authors.forename: Rolf W
authors.initials: RW
authors.lastname: Günther
authors.forename: Andreas Horst
authors.initials: AH
authors.lastname: Mahnken
mesh_terms: D001021:Aortic Valve / Q000000981:diagnostic imaging*; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging; D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000453:epidemiology; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed