Quantification of aortic valve calcification using multislice spiral computed tomography: comparison with atomic...

Area of Science:

• Cardiovascular Imaging
• Medical Physics
• Biomaterials Science

Background:

• Valvular calcification, particularly aortic valve calcification (AVC), is a significant indicator of cardiovascular disease severity.
• Accurate in vivo quantification of AVC is crucial for patient management and risk stratification.
• Multislice spiral computed tomography (MSCT) offers potential for non-invasive assessment of valvular calcification.

Purpose of the Study:

• To validate the accuracy of MSCT in quantifying aortic valve calcification (AVC).
• To compare in vivo MSCT measurements of AVC with in vitro atomic absorption spectroscopy (AAS) of excised human aortic valves.

Main Methods:

• Eighteen patients with severe aortic stenosis underwent 16-detector row MSCT prior to aortic valve replacement.
• Aortic valve calcification was quantified using Agatston, mass, and volumetric AVC scores derived from MSCT.
• Excised aortic valves were analyzed using atomic absorption spectroscopy to determine the true calcification mass (hydroxyapatite content).

Main Results:

• MSCT demonstrated significant correlations between in vivo AVC scores (Agatston, mass, volumetric) and in vitro calcification mass determined by AAS.
• The Agatston AVC score showed the strongest correlation (r=0.80, P=0.0001) with in vitro measurements.
• Linear regression analysis confirmed a significant association between MSCT-derived AVC scores and the degree of hydroxyapatite in the valves.

Conclusions:

• Multislice spiral computed tomography (MSCT) provides accurate in vivo quantification of aortic valve calcification.
• MSCT is a reliable tool for assessing the extent of valvular calcification, aiding in clinical decision-making for patients with aortic stenosis.