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Aortic Valve Calcification as an Incidental Finding at CT of the Elderly: Severity and Location as Predictors of Aortic Stenosis

Franklin Liu1, Courtney A. Coursey1, Cairistine Grahame-Clarke2, Robert R. Sciacca2, Anna Rozenshtein1, Shunichi Homma2 and John H. M. Austin1

1 Department of Radiology, Columbia University Medical Center, 630 W 168th St., New York, NY 10032.
2 Department of Medicine, Columbia University Medical Center, New York, NY 10032.


Figure 1
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  		Fig. 1 —Diagram shows commissures of aortic valve as seen en face. Valve on CT of supine patient is slightly oblique to axial plane but is similar in appearance to this schematic depiction. Ac = central right-posterior commissure, Ap = peripheral right-posterior commissure, Bc = central right-left commissure, Bp = peripheral right-left commissure, Cc = central left-posterior commissure, Cp = peripheral left-posterior commissure.

 

Figure 2
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  		Fig. 2A —Aortic valve calcifications on CT (section thickness, 5 mm) in four elderly patients. Example of severe calcification (subjective grade, 8.5 on 9-point scale; peak gradient, 75 mm Hg; mean gradient, 49 mm Hg), both centrally and peripherally in valve, involving right-left commissure (arrow) and left-posterior commissure (arrowhead). Patient is an 88-year-old woman.

 

Figure 3
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  		Fig. 2B —Aortic valve calcifications on CT (section thickness, 5 mm) in four elderly patients. Example of moderate calcification (subjective grade, 6.5 on 9-point scale; peak gradient, 25 mm Hg; mean gradient, 19 mm Hg) involving center of valve and left-posterior commissure. Patient is an 86-year-old man.

 

Figure 4
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  		Fig. 2C —Aortic valve calcifications on CT (section thickness, 5 mm) in four elderly patients. Example of moderate calcification (subjective grade, 5 on 9-point scale; peak gradient, 17 mm Hg; mean gradient, 10 mm Hg) involving mainly left-posterior commissure and right-left commissure. Patient is an 84-year-old man.

 

Figure 5
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  		Fig. 2D —Aortic valve calcifications on CT (section thickness, 5 mm) in four elderly patients. Example of mild calcification (subjective grade, 3 on 9-point scale; peak gradient, 18 mm Hg; mean gradient, 10 mm Hg) involving mainly right-posterior and right-left commissures centrally. Patient is a 74-year-old woman.

 

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