MDCT detection of mitral valve calcification: prevalence and clinical relevance compared with echocardiography

The purpose of this study was to analyze the prevalence and clinical significance of mitral valve calcification incidentally detected on chest CT scans in comparison with echocardiography.

The data of 390 patients (227 men and 163 women; mean age, 62.4 +/- 12.2 years) who underwent MDCT of the chest and echocardiography were retrospectively evaluated. On MDCT, mitral valve leaflet and annulus calcification were visually graded on a scale of 0-3, with grade 0 denoting no calcification and grade 3 indicating severe calcification. CT findings were correlated with hemodynamic data obtained at echocardiography. Unpaired Student's t tests, chi-square analysis, and a weighted-kappa test were used to compare results.

In 32 (8.2%) of 390 patients, chest MDCT revealed mitral valve leaflet calcification. Fifteen of these patients (15/390, 3.8%) presented with mitral valve stenosis. Excellent agreement (kappa = 0.882) was seen between the presence of mitral valve calcification on MDCT and echocardiographically proven mitral valve sclerosis. Mitral valve leaflet calcification on MDCT and the severity of mitral valve disease on echocardiography showed a substantial agreement (kappa = 0.730). A significant relationship was seen between the degree of mitral valve calcification on MDCT and the echocardiographically determined severity of mitral valve disease (no sclerosis vs mitral sclerosis vs mitral stenosis; p < 0.0001).

Mitral valve leaflet calcification on MDCT indicates mitral valve sclerosis or stenosis. Thus, patients presenting with incidentally detected mitral valve leaflet calcification on chest CT may benefit from a functional assessment with echocardiography.