64-Slice multidetector computed tomography (MDCT) for detection of aortic regurgitation and quantification of severity

Davinder S. Jassal, Michael Shapiro, Tomas G. Neilan, Vithaya Chaithiraphan, Maros Ferencik, Shawn D. Teague, Thomas J. Brady, Eric M. Isselbacher, Ricardo C. Cury

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

BACKGROUND: Recent advances in 64-slice multidetector computed tomography (MDCT) provide an opportunity to assess coronary artery disease, left ventricular function and, potentially, valvular heart disease. OBJECTIVE: To determine the ability of 64-MDCT to both detect and to quantify the severity of aortic regurgitation (AR), as compared with transthoracic echocardiography (TTE). METHODS: We evaluated a total of 64 patients (43 males, mean age 63 ± 11 years), 30 with varying severities of AR as assessed by TTE and 34 matched controls. The severity of AR by TTE was determined using the vena contracta, the ratio of jet to left ventricular outflow tract (LVOT) height, and the ratio of the jet to LVOT cross-sectional area. AR by MDCT was defined as a lack of coaptation of the aortic valve leaflets in diastole and, if detected, the maximum anatomic aortic regurgitant orifice was determined. RESULTS: All 34 control patients without AR were correctly identified by MDCT. There were 14 patients with mild AR, 10 with moderate AR, and 6 with severe AR by TTE. Of these patients, MDCT correctly identified 21 patients with AR (sensitivity 70%, specificity 100%, positive predictive value [PPV] 100%, and negative predictive value [NPV] 79%). Anatomic regurgitant orifice area measured by MDCT correlated well with the TTE-derived vena contracta (r = 0.79, P <0.001), ratio of jet to LVOT height (r = 0.79, P <0.001), and ratio of jet to LVOT cross-sectional area (r = 0.75, P <0.001). CONCLUSIONS: Direct planimetric measurement of the aortic valve anatomic regurgitant orifice area on 64-MDCT provides an accurate, noninvasive technique for detecting and quantifying AR.

Original languageEnglish (US)
Pages (from-to)507-512
Number of pages6
JournalInvestigative Radiology
Volume42
Issue number7
DOIs
StatePublished - Jul 2007
Externally publishedYes

Fingerprint

Aortic Valve Insufficiency
Multidetector Computed Tomography
Echocardiography
Aortic Valve
Heart Valve Diseases
Diastole
Left Ventricular Function
Coronary Artery Disease
Sensitivity and Specificity

Keywords

  • Aortic regurgitation
  • Computed tomography
  • Echocardiography

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

64-Slice multidetector computed tomography (MDCT) for detection of aortic regurgitation and quantification of severity. / Jassal, Davinder S.; Shapiro, Michael; Neilan, Tomas G.; Chaithiraphan, Vithaya; Ferencik, Maros; Teague, Shawn D.; Brady, Thomas J.; Isselbacher, Eric M.; Cury, Ricardo C.

In: Investigative Radiology, Vol. 42, No. 7, 07.2007, p. 507-512.

Research output: Contribution to journalArticle

Jassal, Davinder S. ; Shapiro, Michael ; Neilan, Tomas G. ; Chaithiraphan, Vithaya ; Ferencik, Maros ; Teague, Shawn D. ; Brady, Thomas J. ; Isselbacher, Eric M. ; Cury, Ricardo C. / 64-Slice multidetector computed tomography (MDCT) for detection of aortic regurgitation and quantification of severity. In: Investigative Radiology. 2007 ; Vol. 42, No. 7. pp. 507-512.
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T1 - 64-Slice multidetector computed tomography (MDCT) for detection of aortic regurgitation and quantification of severity

AU - Jassal, Davinder S.

AU - Shapiro, Michael

AU - Neilan, Tomas G.

AU - Chaithiraphan, Vithaya

AU - Ferencik, Maros

AU - Teague, Shawn D.

AU - Brady, Thomas J.

AU - Isselbacher, Eric M.

AU - Cury, Ricardo C.

PY - 2007/7

Y1 - 2007/7

N2 - BACKGROUND: Recent advances in 64-slice multidetector computed tomography (MDCT) provide an opportunity to assess coronary artery disease, left ventricular function and, potentially, valvular heart disease. OBJECTIVE: To determine the ability of 64-MDCT to both detect and to quantify the severity of aortic regurgitation (AR), as compared with transthoracic echocardiography (TTE). METHODS: We evaluated a total of 64 patients (43 males, mean age 63 ± 11 years), 30 with varying severities of AR as assessed by TTE and 34 matched controls. The severity of AR by TTE was determined using the vena contracta, the ratio of jet to left ventricular outflow tract (LVOT) height, and the ratio of the jet to LVOT cross-sectional area. AR by MDCT was defined as a lack of coaptation of the aortic valve leaflets in diastole and, if detected, the maximum anatomic aortic regurgitant orifice was determined. RESULTS: All 34 control patients without AR were correctly identified by MDCT. There were 14 patients with mild AR, 10 with moderate AR, and 6 with severe AR by TTE. Of these patients, MDCT correctly identified 21 patients with AR (sensitivity 70%, specificity 100%, positive predictive value [PPV] 100%, and negative predictive value [NPV] 79%). Anatomic regurgitant orifice area measured by MDCT correlated well with the TTE-derived vena contracta (r = 0.79, P <0.001), ratio of jet to LVOT height (r = 0.79, P <0.001), and ratio of jet to LVOT cross-sectional area (r = 0.75, P <0.001). CONCLUSIONS: Direct planimetric measurement of the aortic valve anatomic regurgitant orifice area on 64-MDCT provides an accurate, noninvasive technique for detecting and quantifying AR.

AB - BACKGROUND: Recent advances in 64-slice multidetector computed tomography (MDCT) provide an opportunity to assess coronary artery disease, left ventricular function and, potentially, valvular heart disease. OBJECTIVE: To determine the ability of 64-MDCT to both detect and to quantify the severity of aortic regurgitation (AR), as compared with transthoracic echocardiography (TTE). METHODS: We evaluated a total of 64 patients (43 males, mean age 63 ± 11 years), 30 with varying severities of AR as assessed by TTE and 34 matched controls. The severity of AR by TTE was determined using the vena contracta, the ratio of jet to left ventricular outflow tract (LVOT) height, and the ratio of the jet to LVOT cross-sectional area. AR by MDCT was defined as a lack of coaptation of the aortic valve leaflets in diastole and, if detected, the maximum anatomic aortic regurgitant orifice was determined. RESULTS: All 34 control patients without AR were correctly identified by MDCT. There were 14 patients with mild AR, 10 with moderate AR, and 6 with severe AR by TTE. Of these patients, MDCT correctly identified 21 patients with AR (sensitivity 70%, specificity 100%, positive predictive value [PPV] 100%, and negative predictive value [NPV] 79%). Anatomic regurgitant orifice area measured by MDCT correlated well with the TTE-derived vena contracta (r = 0.79, P <0.001), ratio of jet to LVOT height (r = 0.79, P <0.001), and ratio of jet to LVOT cross-sectional area (r = 0.75, P <0.001). CONCLUSIONS: Direct planimetric measurement of the aortic valve anatomic regurgitant orifice area on 64-MDCT provides an accurate, noninvasive technique for detecting and quantifying AR.

KW - Aortic regurgitation

KW - Computed tomography

KW - Echocardiography

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