CLINICAL RESEARCH: CARDIAC IMAGING
Multislice Computed Tomography for Detection of Patients With Aortic Valve Stenosis and Quantification of Severity
Gudrun M. Feuchtner, MD*,*,
Wolfgang Dichtl, MD ,
Guy J. Friedrich, MD,
Mathias Frick, MD,
Hannes Alber, MD,
Thomas Schachner, MD ,
Johannes Bonatti, MD,
Ammar Mallouhi, MD*,
Thomas Frede, MD*,
Otmar Pachinger, MD,
Dieter zur Nedden, MD* and
Silvana Müller, MD
* Clinical Department of Radiology II, Innsbruck Medical University, Innsbruck, Austria
Clinical Department of Cardiology, Innsbruck Medical University, Innsbruck, Austria
Clinical Department of Cardiac Surgery, Innsbruck Medical University, Innsbruck, Austria
Manuscript received January 3, 2005;
revised manuscript received November 2, 2005,
accepted November 15, 2005.
* Reprint requests and correspondence: Dr. Gudrun Maria Feuchtner, Clinical Department of Radiology II, Innsbruck Medical University, Anichstr. 35, A-6020 Innsbruck, Austria (Email: Gudrun.Feuchtner{at}uibk.ac.at).
OBJECTIVES: The purpose of this study was to evaluate whether multislice computed tomography (MSCT) provides a reliable, noninvasive imaging modality for identification of patients with degenerative aortic valve stenosis (AS) by quantifying the aortic valve area (AVA) in comparison to the accepted diagnostic standard transthoracic echocardiography (TTE).
BACKGROUND: Management of patients with degenerative AS is based on the severity of disease. The severity of AS in clinical practice is assessed by TTE and classified as mild, moderate, or severe according to the AVA.
METHODS: Forty-six patients were examined with contrast-enhanced, electrocardiogram-gated, 16-row MSCT for the evaluation of the diagnostic accuracy. In 30 patients, quantification of the AVA with MSCT was compared to TTE using the continuity equation with Doppler velocity-time integral for calculation of the AVA.
RESULTS: Sensitivity of MSCT for the identification of patients with degenerative AS was 100%, and the specificity was 93.7%. Thirty of 46 patients had AS determined by TTE. Quantification of AVA by MSCT (mean AVA = 0.94 cm2) in patients with AS showed a good correlation to TTE (r = 0.89; p < 0.001). Bland-Altman plot illustrated good intermodality agreement between the two methods (limits of agreement, 0.20; 0.29).
CONCLUSIONS: Multislice computed tomography may provide an accurate, noninvasive imaging technique for detection of patients with AS and quantification of AVA.
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Abbreviations and Acronyms
| | AS = aortic stenosis | | AVA = aortic valve area | | CAD = coronary artery disease | | CMR = cardiac magnetic resonance imaging | | CT = computed tomography | | LVOT = left ventricular outflow tract | | MSCT = multislice computed tomography | | TEE = transesophageal echocardiography | | TTE = transthoracic echocardiography |
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191(6):
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29(4):
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Noncoronary applications of cardiac multidetector row computed tomography.
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November 1, 2007;
93(11):
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|
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|
|
|
|
|
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September 1, 2007;
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|
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|
|
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July 1, 2007;
189(1):
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|
|
|
|
|
|
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|
|
|
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January 26, 2007;
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ehl428v1.
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|
|
|
|
|
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48(11):
2354 - 2354.
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|
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