CALCIFICATION OF AORTIC-VALVE DETECTED INCIDENTALLY ON CT SCANS - PREVALENCE AND CLINICAL-SIGNIFICANCE

OBJECTIVE. Aortic valve calcification that is visualized on chest radi ographs is considered a marker for clinically significant aortic steno sis, but the clinical importance of this finding on CT is unknown. Acc ordingly we studied the prevalence and clinical relevance of aortic va lve calcification found incidentally on CT scans of the chest. MATERIA LS AND METHODS. After comparing computer records of chest CTs and echo cardiograms, we identified 109 patients who underwent both studies dur ing a 2-year period. Two thoracic radiologists reviewed the CT scans t o identify and quantify aortic valve calcification. The quantity of ao rtic valve calcification was graded on a scale of 1 to 3, with grade 3 indicating the most severe calcification. The prevalence of calcifica tion was correlated with patient age and sex. The findings an CT were correlated with hemodynamic data from echocardiography. At echocardiog raphy, a peak aortic valve gradient of greater than 25 mm Hg was defin ed as abnormal. RESULTS. Aortic valve calcification was noted on CT sc ans in 33 (30%) of the 109 patients. Aortic valve calcification shown by CT was significantly more common in patients more than 65 years old (p < .01). Five (15%) of 33 patients with aortic valve calcification shown by CT had abnormal aortic valve gradients at echocardiography. I n contrast, none of 76 patients without aortic valve calcification sho wn by CT had abnormal aortic valve gradients (p < .01). All five patie nts with abnormal aortic valve gradients had moderate quantities of ao rtic valve calcification seen on CT scans. Two of the five were younge r than 55 years old. CONCLUSION. Aortic valve calcification is a commo n finding on CT scans and is usually clinically insignificant. Neverth eless, some patients with aortic valve calcification on CT have aortic stenosis, particularly those younger than 55 years old and those with moderately dense aortic valve calcification shown by CT. These patien ts may benefit from hemodynamic assessment of the aortic valve by echo cardiography.