Diagnosis of aortic valvular stenosis by multislice cardiac computed tomography.

AIMS Current improvements in spatial, temporal, and contrast resolution of multislice computed tomography (CT) could be useful in the assessment of valvular diseases. We evaluated the diagnostic accuracy of multislice CT for the identification and quantification of aortic valvular stenosis (AS), compared with echography. METHODS AND RESULTS Consecutive patients, referred for coronary CT, were evaluated for AS, by the use of standard electrocardiography-gated 16-slice CT protocol. Multiplanar reformat was applied to systolic phases of the cardiac cycle, with projection on thick slices for measuring the aortic valvular area (AVA). CT results were compared with echocardiographic-based measurement of the AVA. Among 107 enrolled patients, CT analysis of the AVA was feasible in 103. Among the 30 patients with AS, Bland-Altman analysis showed good agreement between the two methods [mean difference -7 mm(2) (-40-25 mm(2))]. CONCLUSION CT analysis of aortic valve is feasible in most cases and allows for reliable diagnosis and quantification of AS.

[1]  Konstantin Nikolaou,et al.  Quantification of obstructive and nonobstructive coronary lesions by 64-slice computed tomography: a comparative study with quantitative coronary angiography and intravascular ultrasound. , 2005, Journal of the American College of Cardiology.

[2]  V. Štísová Effective dose to patient during cardiac interventional procedures (Prague workplaces). , 2004, Radiation protection dosimetry.

[3]  U. Sechtem,et al.  Evaluation of aortic stenosis by cardiovascular magnetic resonance imaging: comparison with established routine clinical techniques , 2004, Heart.

[4]  J. Schulz-Menger,et al.  Magnetic resonance to assess the aortic valve area in aortic stenosis. , 2004, Journal of the American College of Cardiology.

[5]  C. Hamm,et al.  Magnetic resonance to assess the aortic valve area in aortic stenosis: how does it compare to current diagnostic standards? , 2003, Journal of the American College of Cardiology.

[6]  Rolf Fimmers,et al.  Silent and apparent cerebral embolism after retrograde catheterisation of the aortic valve in valvular stenosis: a prospective, randomised study , 2003, The Lancet.

[7]  J. Schulz-Menger,et al.  Quantification of valvular aortic stenosis by magnetic resonance imaging. , 2002, American heart journal.

[8]  R. Gibbons,et al.  ACC/AHA Guidelines for the Management of Patients With Valvular Heart Disease. Executive Summary. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Patients With Valvular Heart Disease). , 1998, The Journal of heart valve disease.

[9]  M. Vanauker,et al.  Turbulent/viscous interactions control Doppler/catheter pressure discrepancies in aortic stenosis. The role of the Reynolds number. , 1996, Circulation.

[10]  K. Karp,et al.  Flow dependence of the aortic valve area in patients with aortic stenosis: assessment by application of the continuity equation. , 1996, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[11]  J. Seward,et al.  Effect of Doppler echocardiography on utilization of hemodynamic cardiac catheterization in the preoperative evaluation of aortic stenosis. , 1996, Mayo Clinic proceedings.

[12]  E D Verrier,et al.  Dependence of Gorlin Formula and Continuit Equation Valve Areas on Transvalvular Volume Flow Rate in Valvular Aortic Stenosis , 1994, Circulation.

[13]  F. Flachskampf,et al.  Planimetry of orifice area in aortic stenosis using multiplane transesophageal echocardiography. , 1993, Journal of the American College of Cardiology.

[14]  Reproducibility of Doppler Echocardiographic Quantification of Aortic and Mitral Valve Stenoses: Comparison Between Two Echocardiography Centers , 1991 .

[15]  H. Ihlen,et al.  Reproducibility of echocardiographic estimates of the area of stenosed aortic valves using the continuity equation. , 1990, International journal of cardiology.

[16]  L. Axel,et al.  Cine MR Imaging in Aortic Stenosis , 1989, Journal of computer assisted tomography.

[17]  D. Altman,et al.  STATISTICAL METHODS FOR ASSESSING AGREEMENT BETWEEN TWO METHODS OF CLINICAL MEASUREMENT , 1986, The Lancet.

[18]  Gd Rotterdam,et al.  High-resolution spiral computed tomography coronary angiography in patients referred for diagnostic conventional coronary angiography , 2006 .

[19]  R. Gibbons,et al.  ACC/AHA Guidelines for the Management of Patients With Valvular Heart Disease. Executive Summary. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Patients With Valvular Heart Disease). , 1998, The Journal of heart valve disease.

[20]  H. Baumgartner,et al.  Determination of aortic valve area by Doppler echocardiography using the continuity equation: a critical evaluation. , 1990, Cardiology.