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PubMed2004

3-D CT angiographic demonstration of a neonatal ductus arteriosus aneurysm with development of ductal calcification: are the "ductus bump", ductus arteriosus aneurysm, and ductal calcification related?

A "ductus bump" was noted as an incidental finding on a chest radiograph in a newborn infant with congenital cystic adenomatoid malformation. A chest CT performed on the first day of life demonstrated this to be a ductus arteriosus aneurysm (DAA), which subsequently thrombosed. Ductal calcification was noted on follow-up imaging. We propose that the "ductus bump" may actually be a DAA, which resolves presumably by thrombus formation. Ductal calcification may also be related to the regression of the thrombus.

Aneurysm↗
PubMed1975

Calcification of Schistosoma haematobium eggs: relation of radiologically demonstrable calcification to eggs in tissues and passage of eggs in urine.

The extent of calcification of the bladder in schistosome infected patients is roughly correlated with the number of calcified schistosome eggs present in the bladder. The focal concentration of eggs in the bladder appears to be one major variable, and we estimate that as few as 100,000 eggs per cm2 might be detected in a clinical radiograph. The excretion of calcified eggs in the urine was related to the activity of the schistosome infection and was unaffected by the presence or extent of bladder calcification.

Acute Disease↗
PubMed2006

Electron beam computed tomography evidence of aortic calcification as an independent determinant of coronary artery calcification.

BACKGROUND: Imaging of the aorta has received less attention than imaging of the coronary beds, despite the possible link between aortic and coronary artery disease (CAD). Electron beam computed tomography (EBCT) with 100 ms scanning speed can eliminate pulsation-related motion artifacts. The goals of this study were to evaluate EBCT-detected subclinical atherosclerosis over the whole aorta as in routine abdominal and thoracic CT scans and analyze whether or not the measurements of aortic calcification (AC) can independently predict the presence of coronary artery calcification (CAC), which is a surrogate marker of CAD. METHODS: A consecutive series of 196 adults (male:female, 127:69; mean age, 65.9 +/- 10.5 years) were enrolled for EBCT examinations of the coronary arteries and whole aorta. CAC and AC were calculated by the Agatston method. Major cardiovascular risk factors were also recorded. RESULTS: The greatest amount of AC was seen at the abdominal aorta, followed by the descending aortic arch, thoracic aorta, and ascending aorta. Total AC was significantly correlated with CAC (r = 0.51, p < 0.001). After adjustment for major cardiovascular risk factors of age, gender, diabetes, hypertension, hypercholesterolemia, and family history, the three independent significant determinants of CAC were abdominal AC, thoracic descending AC, and male gender (model r2 = 0.495, p < 0.001). For receiver operating characteristic analysis in predicting the presence of CAC, the threshold of descending AC was 11, with 68.3% sensitivity and 75.0% specificity. The optimal threshold of abdominal AC was 123, with 74.1% sensitivity and 67.9% specificity. CONCLUSION: AC values in different portions of the aorta are independent predictors for the presence of CAC.

Adult↗
PubMed1987

Severe subcutaneous calcification in the 'CREST' syndrome: evidence of high turnover of calcific deposits.

Four patients with mild CREST syndrome and extensive subcutaneous calcification have been studied over a 5-year period. There was no correlation between mineral deposition and other features of the disease and no obvious clinical or metabolic cause of the calcification. Mineral deposits, identified as crystalline carbonated apatite, were very labile. A clear pattern of radiographic evolution was apparent. Bone scans showed a higher uptake of isotope in new, developing deposits than in older lesions. Spontaneous formation and disappearance of adjacent deposits occurred in some patients. Loss of mineral could not be explained by extrusion through the skin.

Aged↗
PubMed2000

Advanced mitral annular calcification is associated with severe coronary calcification on fast dual spiral computed tomography.

RATIONALE AND OBJECTIVES: Mitral annular calcification (MAC) may be a form of atherosclerosis and can lead to serious clinical consequences. The possible linkage between the presence and extent of MAC and coronary calcium score on CT is unknown. The goal of the present study was to investigate whether an association between MAC and coronary calcification (CC) exists in hypertensive patients with increased cardiovascular risk. METHODS: Five hundred twenty-two patients (284 men and 238 women, age range 52-80 years, mean 65+/-6 years), who were recruited to the INSIGHT study in the authors' region, underwent fast spiral CT of the heart as well as an echo Doppler examination. MAC was defined as advanced when the thickness of the calcium deposit was 5 mm or more; it was defined as trivial otherwise. RESULTS: The advanced MAC group comprised 62 patients, the trivial MAC group 215 patients, and the control group (without MAC) 245 patients. The prevalence of nonsevere CC was similar among the study groups, whereas the prevalence of severe CC (total calcium score >300) and the prevalence of proven coronary artery disease were associated with the presence and extent of MAC: respectively, 12% and 15% in control patients, 18% and 20% in patients with trivial MAC, and 29% and 29% in patients with advanced MAC. Multivariate analysis identified advanced MAC as an independent variable associated with severe CC and proved coronary artery disease. CONCLUSIONS: The results of this study demonstrated an association of advanced MAC and severe CC on spiral CT and proved coronary artery disease on the clinical level. Thus, advanced but not trivial MAC makes the noninvasive diagnosis of coronary atherosclerosis more likely and presumably could be considered as a new indication for further coronary evaluation in high-risk patients.

Aged↗
PubMed1989

Spontaneous calcific cerebral embolus from a calcific aortic stenosis in a middle cerebral artery infarct.

Calcific emboli from a calcific aortic stenosis is an uncommon event, usually following local trauma, as from cardiac surgery or left heart catheterization or as a sequel to bacterial endocarditis. We report what we believe to be the first case of a spontaneous calcareous emboli demonstrated by cranial computed tomography. In this patient, systemic hypertension and mild aortic insufficiency may have caused increasing mechanical forces acting on the aortic cusps and may have precipitated embolism.

Aged↗
PubMed1990

[Assessment of the relation between bone mineral metabolism and mitral annular calcification or aortic valve sclerosis--the relation between mitral annular calcification and postmenopausal osteoporosis in elderly patients].

We assessed the effect of bone mineral metabolism on mitral annular calcification (MAC) and aortic valve sclerosis or calcification (AVS) in elderly patients. Both MAC and AVS were derived by 2-D echocardiography, and bone mineral content (BMC) of vertebral bodies was obtained by quantitative computed tomography using a calibrated phantom system. The calcium (Ca), phosphate (P), parathyroid hormone (PTH-c), calcitonin (CLT), vitamin-D (25-(OH)D) and osteocalcin (OC) in serum were examined within a period of one month. The 265 patients were classified into three groups according to the echocardiographic findings. The control (CNT) group consisted of 122 patients (44 males, 78 females) without MAC or AVS, the MAC group consisted of 64 patients (16 males, 48 females) with MAC, and the AVS group consisted of 79 patients (31 males, 48 females) with AVS. 1) The incidences of MAC and AVS in both males and females were found to increase in proportion to aging. 2) The incidence of MAC in females (28%) was higher than that of males (18%). 3) AVS in males (34%) was more frequent than in females (27%). 4) In females of the eighth and ninth decade of age, BMC in the MAC group was significantly less than in the CNT group (eighth p less than 0.05, ninth p less than 0.01), but no difference was seen in males. 5) In both males and females, BMC in the AVS group was not significantly different from that in the CNT group. 6) In all subjects of the eighth and ninth decades, the serum levels of Ca and P were within normal ranges. PTH-c, CLT and 25-(OH)D showed subnormal or lower normal values, while OC showed supernormal or upper normal values. However, the was no difference among the three groups. These results suggest that MAC may be attributed to ectopic calcium deposit, probably related to decalcification from bone in postmenopausal osteoporosis. However, in the present study, there was no relation between the incidence of MAC and humoral factors of calcium metabolism. On the other hand, AVS may be caused by other factors, mainly prolonged and sustained pressure or stress loading.

Aged↗
PubMed2006

Adult calcific aortic stenosis and Chlamydia pneumoniae: the role of Chlamydia infection in valvular calcification.

BACKGROUND: Adult calcific aortic stenosis is a well-known clinical entity but its pathophysiology and cellular mechanism have yet to be defined. OBJECTIVES: To determine whether there is an association between the presence and severity of adult calcific aortic stenosis and Chlamydia pneumoniae seropositivity. METHODS: Forty adult patients (23 women, 17 men) were divided into three groups according to echocardiographic aortic valve area: Group A - 7 symptomatic subjects (age 67 +/- 7 years) with normal aortic valve and normal coronary angiogram, Group B - 16 patients (age 73 +/- 6) with moderate ACAS (AVA > 0.8 < or = 1.5 cm2), and Group C - 17 patients (age 76 +/- 7) with severe ACAS (AVA +/- 0.8 cm2). We tested for immunoglobulins M, G and A as retrospective evidence of C. pneumoniae infection using the micro-immunofluorescence method. Past C. pneumoniae infection was defined by IgG titer > 16 < or = 512. RESULTS: No patients in group A showed positive Ig for C. pneumoniae. IgM was not detected in any of the patients with ACAS (groups B and C) while 2 of 17 patients (12%) in group C showed IgA for the pathogen. High titers of IgG were found in 14 of 33 (42%) of the patients with moderate or severe ACAS: 5 of 16 (31%) in group B and 9 of 17 (53%) in group C (P = 0.2). Both groups had the same prevalence of coronary artery disease (66%). AVA was lower in IgG-seropositive patients than in the seronegative group (0.88 +/- 0.3 cm2 vs. 1.22 +/- 0.4 cm2, respectively, P = 0.02). CONCLUSIONS: Past C. pneumoniae infection may be associated with a higher prevalence and greater severity of ACAS.

Aged↗
PubMed1976

Spontaneous calcific emboli from calcific mitral annulus fibrosus.

Clinically important complications resulting from calcific mitral annulus fibrosus (CMAF) are unusual. They include mitral regurgitation, mitral stenosis, and complete heart block. In one patient with massive CMAF associated with multiple systemic calcific emboli originating from the mitral valve, the emboli were the cause of multiple brain infarcts and a clinical course of unexplained neurological deterioration. We believe that this is the first report of such a complication occurring with CMAF.

Brain↗
PubMed1978

Calcifications within the duct of Wirsung in calcific pancreatitis.

A review of abdominal radiographs of 50 patients with the clinical diagnosis of chronic pancreatitis showed calcific pancreatitis in 27 patients. Ten patients had severe pain associated with weight loss. Five had obstruction of the duct of Wirsung: one by a pseudocyst and four by large stones near the ampulla of Vater. The radiologic workup presented emphasizes the need to study the duct of Wirsung in patients with chronic pancreatitis to guide the surgical approach for relief of intractavle pain. Theories regarding the pathophysiology of calcium deposition and stone formation and migration are reviewed.

Alcoholism↗
PubMed2001

How much interdisciplinarity is required to understand vascular calcifications? Formulation of four basic principles of vascular calcification.

Four potential basic mechanisms of arterial wall calcification were identified: 1) loss of inhibitory action on crystallization of biological macromolecules, 2) nucleation of calcium phosphate precipitation by dead cells and/or their membranes, 3) autocatalytic nucleation of cholesterol by antibodies against cholesterol crystals, and 4) formation of bone-like structures in advanced atherosclerotic lesions. The relevance and interplay of these mechanisms has not yet been clarified. Their elucidation will require a concerted effort of natural scientists and medical specialists.

Animals↗
PubMedDate not supplied

Unusual feature of soft-tissue calcification in chronic renal failure: tumoral calcification.

Two cases of massive calcification in dialysed patients are described with computerized tomography correlation: one in the abdominal/pelvic cavity, which is a rare location, and the other in the abdominal wall. The cause of these calcified deposits is multifactorial and complex. Usually painless, they may cause restriction of joint movement by virtue of their bulky size.

Abdominal Muscles↗
PubMed1975

[Tumour-like calcification and metastic calcification in teritary hyperparathyroidism (author's transl)].

Tertiary hyperparathyroidism in a 47-year-old woman was accompained by metastatic and "tumour-like" calcifications. The latter were characterized by tumours of different-sized calcium-containing pseudocyts, surrounded by a cell-rich tissue predominantly containing fibroblasts, histocytes and foreign-body giant cells, which in their cytoplasm contained Cossa-positive particles. Pathogenesis and aetiology of the disease are largely unknown.

Autopsy↗
PubMed2000

The radiographic quantitation of aortic valve calcification: implications for assessing bioprosthetic valve calcification in vitro.

Calcification of natural aortic and bioprosthetic heart valves is a poorly understood phenomenon that results in valvular obstruction and tissue failure. We describe a non-destructive quantitative computed microtomographic (QCT) technique for determining both calcium content and local calcium distribution within explanted valves. As a reference standard, a dual-energy x-ray absorptiometry (DEXA) system with an accuracy demonstrated to be within 1% of the true calcium mass of test material was used to obtain the total calcium content of 24 human aortic valve cusps recovered at autopsy from patients aged 51-80 years. These cusps were then scanned using our unique volume QCT scanner, with multiple x-ray projections acquired by rotating the explanted tissue through a single axis of rotation. A three-dimensional cross-sectional map was reconstructed for each cusp. Voxel size was 0.003 mm3 and a calibration phantom was used to calculate calcium content. The minimum detection limit for calcium mass was 1 mg within the whole cusp. The DEXA and QCT scans were compared with respect to total calcium content, which ranged from 0 to 15 mg. An excellent correlation between the two independent techniques was demonstrated with an r2 value of 0.94 (p < 0.001). Non-destructive microtomographic CT scanning provided excellent volumetric density measurements, with quantitative 3D images permitting an assessment of any individual area of the cusp for calcium content and spatial distribution. This new approach to valve tissue analysis allows for subsequent histologic assessment.

Absorptiometry, Photon↗
PubMed2004

Hutchinson-Gilford progeria syndrome with severe calcific aortic valve stenosis and calcific mitral valve.

The case of a 12-year-old girl with clinical features of progeria with severe calcific valvar aortic stenosis is presented. The mitral valve showed the presence of calcium, and peripheral vascular disease was also present, though there was no family history of this. Aortic valve replacement was deferred because of insufficient data relating to this condition. The genetics and phenotypic mechanisms of the disease are reviewed. In view of the association of progeria with valve disease, all patients should undergo electrocardiography and echocardiography as part of their routine work-up.

Aortic Valve Stenosis↗