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A 72 year old lady underwent multislice computed tomography of the thorax in order to assess the ascending aorta before aortic valve replacement for calcific aortic stenosis. In order to improve image quality the study was prospectively triggered to mid-to-late diastole (heart rate 72 beats/min, 273 ms scan window timed to complete at 85% of the cardiac cycle). A gantry rotation time of 0.5 s, and acquisition of 4 × 2.5 mm slices gave excellent image resolution of the ascending aorta. By removal of surrounding non-calcified structures, using volume rendering techniques, striking “incidental” three dimensional images of the heavily calcified aortic valve were reconstructed. There is increasing interest in quantification of aortic valve calcification. Computed tomography is unique among imaging modalities in its ability to quantify calcification accurately, and traditional “scoring” techniques based on the assessment of coronary artery calcification have been modified to assess aortic valve calcification.
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