Diagnosis of aortic valvular stenosis by multislice cardiac computed tomography

Bouvier, Erik; Logeart, Damien; Sablayrolles, Jean‐Louis; Feignoux, Jacques; Scheublé, C; Touche, T; Thabut, Gabriel; Cohen‐Solal, Alain

doi:10.1093/eurheartj/ehl273

Cited by 72 publications

(33 citation statements)

References 18 publications

(16 reference statements)

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“…MDCT can visualize the anatomic structure of cardiac valves with similar accuracy as TEE without the limitations of varying acoustic windows and heavy calcification that can limit anatomic assessment. 2 In addition, MDCT can be used in patient populations that are unable to undergo MRI studies, such as patients with claustrophobia, pacemakers, and implantable defibrillators. Therefore, MDCT can be an extremely useful supplemental imaging technique in the noninvasive evaluation of cardiac valves.…”

Section: Rationale For Cardiac Mdctmentioning

confidence: 99%

“…MDCT can be considered an alternative to echocardiography for measuring aortic valve area because it is neither operator nor acoustic window dependent. 2 Figure 1 shows various MDCT trileaflet aortic valve abnormalities. A meta-analysis of 14 studies that involved 16, 40, and 64-slice MDCT showed a trend toward slight overestimation of the aortic valve area on planimetry by MDCT compared with TTE (bias 10.08 cm 2 ; 95% CI 0.04-0.13 cm 2 ; P 5 0.0001), and good correlation when comparing MDCT with TEE planimetric assessment of the aortic valve (bias 20.02 cm 2 ; 95% CI 0.16-0.11 cm 2 ; P 5 0.71).…”

Section: Aortic Stenosismentioning

confidence: 99%

“…Datasets acquired from routine coronary CT angiography (CTA) also provide valuable information on valvular anatomy and function without the need for additional imaging protocols. 2 Moreover, the evolution of MDCT has resulted in marked improvement in temporal and spatial resolution during image acquisition. 3 This article discusses the effectiveness of MDCT in evaluating the normal structure and function of the 4 major cardiac valves, as well as its diagnostic utility in analyzing valve pathology, primary valve tumors, and endocarditis.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of valvular disease by cardiac computed tomography assessment

Buttan

Yang

Budoff

et al. 2012

Journal of Cardiovascular Computed Tomography

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Section: Rationale For Cardiac Mdctmentioning

confidence: 99%

Section: Aortic Stenosismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Evaluation of valvular disease by cardiac computed tomography assessment

Buttan

Yang

Budoff

et al. 2012

Journal of Cardiovascular Computed Tomography

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“…There have been several studies [10][11][12][13] performed with triphasic injection protocol, which consists of two contrast boluses at different flow rates followed by a saline chaser. In general, the aim of any injection protocol is to achieve an adequate, consistent, and homogeneous contrast enhancement in the coronary arteries and the cardiac chambers, in order to facilitate depiction of anatomy and pathology 1 .…”

Section: Introductionmentioning

confidence: 99%

Triphasic Contrast Agent Injection in 64-MDCT Coronary Artery Angiography

et al. 2014

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Purpose: To evaluate image quality and cardiovascular enhancement after triphasic injection in 64-slice-CT coronary angiography (c-CTA). Methods: c-CTA of twenty-two asymptomatic patients following triphasic injection (65ml-contrast bolus + mixed 30ml-contrast and 20ml-saline bolus + 50ml-saline chaser) were retrospectively reviewed. Attenuation in the great vessels, cardiac chambers, and coronary arteries in 13 places were measured by region of interest. Also, differences in enhancement between the right coronary artery (RCA) and the right cardiac chambers (RCA versus right atrium or RA; RCA versus right ventricle or RV) were analyzed. Quality of images and contrast-related streak artifacts were subjectively assessed by 2 radiologists in consensus on a 4-point scale. Results: There was excellent enhancement in the coronary arteries (mean range 395.84-429.90 Hounsfield Units or HU), ascending aorta (mean 448.58 HU), descending aorta (mean 433.49 HU), and pulmonary artery (mean 385.45 HU). There was adequate difference in attenuation between RCA versus RA (mean range 126.12-148.43 HU) and RCA versus RV (mean range 50.34-72.66 HU). There was high and inhomogeneous attenuation in the superior vena cava (mean 509.23 HU). The quality of images was considered good (mean 1.6; 1 = excellent, 2 = good, 3 = moderate, 4 = low) and contrast-related streak artifacts were considered low (mean 2.9; 1 = severe, 2 = moderate, 3 = low, 4 = absent) by two radiologists. Conclusions: Our triphasic contrast injection provides excellent cardiovascular enhancement with minimal contrastrelated streak artifacts, particularly in the right cardiac chambers while adequately differentiating the right coronary artery.

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“…In clinical practice, there are 2 possible implementations of cardiac CT in patients with aortic stenosis: First, the AVA should be measured [2,[8][9][10][11]25] in all patients undergoing coronary or cardiac CT for any clinical indications, if aortic valve calcification is visible. Virtually 100% of patients with aortic stenosis will exhibit calcification, and vice versa at least 13% of patients with intermediate pre-test probability referred to coronary CT angiography (mean age 57 years) [12] will present with valvular calcification, with a rising prevalence with age.…”

mentioning

confidence: 99%