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Mitral Regurgitation: Quantification with 16–Detector Row CT—Initial Experience¹

¹ From the Institute of Diagnostic Radiology (H.A., S.W., B.B., S.L., L.M.D., B.M., T.B.), Institute of Anesthesia, Division of Cardiovascular Anesthesia (D.A.B.), and Clinic for Cardiovascular Surgery (A.P.), University Hospital Zurich, Raemistrasse 100, CH-8091 Zurich, Switzerland. Received December 31, 2004; revision requested March 3, 2005; revision received March 15; final version accepted April 15. Supported by the National Center of Competence in Research, Computer Aided and Image Guided Medical Interventions, of the Swiss National Science Foundation. Address correspondence to H.A. (e-mail: hatem.alkadhi{at}usz.ch).

Purpose: To prospectively determine if retrospectively electrocardiographic (ECG)-gated multi–detector row computed tomography (CT) with a 16–detector row CT scanner can depict mitral regurgitation and enable quantification of the severity of the disease.

Materials and Methods: The study had institutional review board approval, and patients gave informed consent. Nineteen patients with mitral regurgitation (10 men, nine women; mean age, 66 years ± 9 [standard deviation]; range, 41–83 years) and 25 patients without mitral regurgitation (14 men, 11 women; mean age, 68 years ± 9; range, 43–83 years) as determined with transesophageal color Doppler echocardiography and ventriculography underwent retrospectively ECG-gated 16–detector row CT. Twenty CT data sets covering the entire mitral valve apparatus were reconstructed in 5% steps of the R-R interval for each patient, and data analysis was performed with four-dimensional software. Using planimetry, two readers measured in consensus the area of the regurgitant orifice during systole. These measurements were compared with semiquantitative data from transesophageal echocardiography and ventriculography by using Spearman rank order correlation coefficients.

Results: In the 25 patients without mitral regurgitation, no regurgitant orifice during systole could be detected with multi–detector row CT. In the 19 patients with mitral regurgitation, a regurgitant orifice could be visualized in all cases. The mean regurgitant orifice area at CT—45 mm² ± 34 (range, 10–148 mm²)—correlated significantly with the results at transesophageal echocardiography (r = 0.807, P < .001) and ventriculography (r = 0.922, P < .001).

Conclusion: Planimetric measurements of the regurgitant orifice area at retrospectively ECG-gated 16–detector row CT enable quantification of mitral regurgitation.

Supplemental material: radiology.rsnajnls.org/cgi/content/full/2381042216/DC1

© RSNA, 2005