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Updated: Aug 14, 2026

Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Calcium scoring of aortic valve calcification in aortic valve stenosis with a multislice computed tomography scanner:
G Mühlenbruch1, J E Wildberger, R Koos
1Department of Diagnostic Radiology, Department of Cardiology, Institute of Medical Statistics, University Hospital (RWTH) Aachen, Germany. gmuehlen@rad.rwth-aachen.de
Purpose:
Previous studies have shown a positive correlation between amount of aortic valve calcification (AVC) and degree of aortic valve stenosis (AVS). We have investigated whether calcium scoring of AVC from contrast-enhanced images is reliable.
Material And Methods:
Nineteen patients with suspected AVS underwent retrospectively ECG-gated multislice computed tomography (MSCT). Standardized scan protocols were applied prior to (120 KV, 133 mAseff) and after (120 KV, 500 mAseff) the administration of non-ionic contrast material. Image reconstruction was performed at 60% of the RR interval (slice thickness 3 mm, reconstruction increment 2 mm). AVC was quantified using Agatston score and calcium mass. The number of lesions was calculated. All nonenhanced images were scored using thresholds of 130 HU and 350 HU. Contrast-enhanced images were assessed with a threshold of 350 HU exclusively.
Results:
Fifteen patients with AVCs were included in the statistical analysis. The mean Agatston score (calcium mass) in non-enhanced images was 2888.4 +/- 2844.4 (694.2 mg +/- 869.3 mg). Altering the threshold from 130 HU to 350 HU led to a 58.2% (30.5%) decrease in the AVC score (P values < 0.001). Contrast-enhanced images showed an increased Agatston score (calcium mass) of 56.2% (33.5%) compared to non-enhanced images (P values <0.05) with the same threshold of 350 HU.
Conclusion:
Quantification of AVC from contrast-enhanced images is not reliable, as contrast material simulates calcification.
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