Mitral valve regurgitation: Assessment with dual source computed tomography

To evaluate diagnostic accuracy of dual source computed tomography (DSCT) for evaluation of mitral valve regurgitation (MR) with transthoracic echocardiography (TTE). We evaluated a total of 60 patients who underwent both DSCT and TTE. According to Doppler echocardiography, we divided the patients into two groups: 40 with MR and 20 without MR. We assessed the presence and severity of MR on the basis of systolic regurgitant orifice size on DSCT images and compared the results with two-dimensional Doppler echocardiography. We graded the morphology of the mitral apparatus of the 40 patients with MR using Real-time three-dimensional echocardiography( RT-3DE) and DSCT. Features such as calcification, valve thickening, valve prolapse, flail leaflet movement and local limitation of stretching on DSCT images were used to diagnose each patient and the results were compared with RT-3DE findings. Diagnosis of MR by DSCT was in good agreement with traditional two-dimensional Doppler echocardiography (Kappa = 0.883, P <; 0.01); for the severity of MR, the correlation coefficient between the two methods was 0.94. DSCT was able to diagnose five different types of pathologic morphology with no statistically significant difference to RT-3DE. DSCT can provide quick, multi-angle, multiphase observation of the mitral valve. Also DSCT can accurately assess the severity of regurgitation and pathologic morphology in MR disease.