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
Clinical Department of Cardiology
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.
|
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 |
|
This article has been cited by other articles:
|
|
|
|
 
P. Schoenhagen, E. M. Tuzcu, S. R. Kapadia, M. Y. Desai, and L. G. Svensson
Three-dimensional imaging of the aortic valve and aortic root with computed tomography: new standards in an era of transcatheter valve repair/implantation
Eur. Heart J.,
September 1, 2009;
30(17):
2079 - 2086.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. M. Feuchtner, P. Stolzmann, W. Dichtl, T. Schertler, J. Bonatti, H. Scheffel, S. Mueller, A. Plass, L. Mueller, T. Bartel, et al.
Multislice computed tomography in infective endocarditis comparison with transesophageal echocardiography and intraoperative findings.
J. Am. Coll. Cardiol.,
February 3, 2009;
53(5):
436 - 444.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. M. LaBounty, B. Sundaram, P. Agarwal, W. A. Armstrong, E. A. Kazerooni, and E. Yamada
Aortic Valve Area on 64-MDCT Correlates with Transesophageal Echocardiography in Aortic Stenosis
Am. J. Roentgenol.,
December 1, 2008;
191(6):
1652 - 1658.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. M. Feuchtner, W. Dichtl, S. Muller, D. Jodocy, T. Schachner, A. Klauser, and J. O. Bonatti
64-MDCT for Diagnosis of Aortic Regurgitation in Patients Referred to CT Coronary Angiography
Am. J. Roentgenol.,
July 1, 2008;
191(1):
W1 - W7.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Schroeder, S. Achenbach, F. Bengel, C. Burgstahler, F. Cademartiri, P. de Feyter, R. George, P. Kaufmann, A. F. Kopp, J. Knuuti, et al.
Cardiac computed tomography: indications, applications, limitations, and training requirements: Report of a Writing Group deployed by the Working Group Nuclear Cardiology and Cardiac CT of the European Society of Cardiology and the European Council of Nuclear Cardiology
Eur. Heart J.,
February 2, 2008;
29(4):
531 - 556.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. F. Tops, S. C. Krishnan, J. D. Schuijf, M. J. Schalij, and J. J. Bax
Noncoronary applications of cardiac multidetector row computed tomography.
J. Am. Coll. Cardiol. Img.,
January 1, 2008;
1(1):
94 - 106.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. Burgstahler and S. Schroeder
Magnetic resonance imaging versus computed tomography for the detection of coronary stenosis: do we really have to focus on "stenoses"?
Heart,
November 1, 2007;
93(11):
1322 - 1324.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J.-P. Laissy, D. Messika-Zeitoun, J.-M. Serfaty, V. Sebban, E. Schouman-Claeys, B. Iung, and A. Vahanian
Comprehensive evaluation of preoperative patients with aortic valve stenosis: usefulness of cardiac multidetector computed tomography
Heart,
September 1, 2007;
93(9):
1121 - 1125.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A.-C. Pouleur, J.-B. le Polain de Waroux, A. Pasquet, J.-L. J. Vanoverschelde, and B. L. Gerber
Aortic Valve Area Assessment: Multidetector CT Compared with Cine MR Imaging and Transthoracic and Transesophageal Echocardiography
Radiology,
September 1, 2007;
244(3):
745 - 754.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. M. Feuchtner, S. Muller, J. Bonatti, T. Schachner, C. Velik-Salchner, O. Pachinger, and W. Dichtl
Sixty-Four Slice CT Evaluation of Aortic Stenosis Using Planimetry of the Aortic Valve Area
Am. J. Roentgenol.,
July 1, 2007;
189(1):
197 - 203.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Goland, A. Trento, K. Iida, L. S C Czer, M. De Robertis, T. Z Naqvi, K. Tolstrup, T. Akima, H. Luo, and R. J Siegel
Assessment of aortic stenosis by three-dimensional echocardiography: an accurate and novel approach
Heart,
July 1, 2007;
93(7):
801 - 807.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
Other articles noted
Evid. Based Med.,
April 1, 2007;
12(2):
63 - 64.
[Full Text]
[PDF]
|
|
|
|
|
|
|
Authors/Task Force Members, A. Vahanian, H. Baumgartner, J. Bax, E. Butchart, R. Dion, G. Filippatos, F. Flachskampf, R. Hall, B. Iung, et al.
Guidelines on the management of valvular heart disease: The Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology
Eur. Heart J.,
January 26, 2007;
(2007)
ehl428v1.
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. M. Feuchtner, W. Dichtl, and S. Muller
Reply
J. Am. Coll. Cardiol.,
December 5, 2006;
48(11):
2354 - 2354.
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. Veyrat
Physiologic Timing for Objective Checking of Instantaneous Maximal Aortic Stenotic Area
J. Am. Coll. Cardiol.,
December 5, 2006;
48(11):
2353 - 2353.
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. Bamgartner
Is there a role for multislice computed tomography in aortic stenosis?
Eur. Heart J.,
December 2, 2006;
27(24):
2923 - 2924.
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. Lavi and S. Lavi
Coronary artery imaging with 64-slice computed tomography from cardiac surgical perspective
Eur. J. Cardiothorac. Surg.,
November 1, 2006;
30(5):
813 - 814.
[Full Text]
[PDF]
|
|
|
|
