title: Incidental aortic valve calcification on CT scans: significance for bicuspid and tricuspid valve disease.
abstract: OBJECTIVE
  The aim of this study was to evaluate the role of incidental aortic valve calcification on routine computed tomographic scans as a marker for stenosis, as assessed by echocardiography, in patients with bicuspid aortic valve (BAV) and tricuspid aortic valve.
  
  
  METHODS
  Computed tomographic and echocardiographic studies were retrospectively reviewed for 182 consecutive, unselected patients and 426 patients identified by a record search for "aortic valve calcification." Location and severity of valve calcification were correlated with aortic valve morphology and stenosis. Differences between subgroups were assessed using χ(2) or Fisher's exact tests.
  
  
  RESULTS
  In unselected patients, calcification was present in 25.8% with tricuspid aortic valves (46 of 178) and 75% (three of four) with BAV. In patients selected for valve calcification, the average age of those with tricuspid aortic valves (n = 395) was 14.3 years older than those with BAV (n = 31). Patients with BAV were more likely to have severe calcification (87% vs 50%, P < .001), and if severe calcification was present, it was more likely to involve only the valve leaflets (41% vs 9%, P < .001) and result in aortic stenosis (85% vs 58%, P = .006). Patients aged < 60 years with severe calcification were more likely to have BAV (56% vs 7%; odds ratio, 7.9; 95% confidence interval, 3.4-18.7).
  
  
  CONCLUSIONS
  Aortic valve calcification was found 14 years earlier in patients with BAV and was more severe and strongly linked to aortic stenosis. Valve calcification on computed tomographic scans should be considered a marker for BAV if found before the seventh decade.
authors: Department of Radiology, University of California, San Francisco, 505 Parnassus Avenue, Box 0628, San Francisco, CA 94143-0628, USA. michael.hope@ucsf.edu
authors: Michael D
authors: MD
authors: Hope
authors: Thomas H
authors: TH
authors: Urbania
authors: John-Paul J
authors: JP
authors: Yu
authors: Sam
authors: S
authors: Chitsaz
authors: Elaine
authors: E
authors: Tseng
mesh_terms: D000368:Aged; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D002140:California / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D006801:Humans; D033162:Incidental Findings; D008297:Male; D008875:Middle Aged; D008946:Mitral Valve Stenosis / Q000000981:diagnostic imaging / Q000453:epidemiology*; D015995:Prevalence; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*; D014264:Tricuspid Valve Stenosis / Q000000981:diagnostic imaging / Q000453:epidemiology*