title: Dynamic cine mode imaging of the normal aortic valve using 16-channel multidetector row computed tomography.
abstract: BACKGROUND
  We investigated the feasibility and image quality of dynamic cine-mode imaging of the normal aortic valve using multidetector row computed tomography (MDCT).
  
  
  METHODS
  We acquired contrast-enhanced retrospectively echocardiography (ECG)-gated cardiac MDCT datasets of 35 patients (mean age, 62 years; range, 53-77) who received a transoesophageal echocardiography (TOE) precedent to cardiac bypass graft surgery. Twenty data sets in 5% steps of the R-R interval were reconstructed, and data analysis was performed using a 4D software. Read-out of the MDCT data was performed in parallel and perpendicular planes, similar to TOE standard planes, by 2 independent, blinded readers using a 4-point Likert scale (best score: 4) for the following parameters: image quality of the aortic valve components, contrast media enhancement, contrast media inflow related artifacts, and ECG gating-related artifacts. The aortic valve area (AVA) was measured planimetrically and was compared between TOE and MDCT.
  
  
  RESULTS
  The best phase for assessing the open valve using MDCT was at 5% and the closed valve at 65% of the cardiac cycle. The mean image quality scores for cine-mode MDCT ranged between 3.26 and 3.75, with inter-reader agreements ranging between good (kappa = 0.723) and excellent (kappa = 1.00). They did not differ significantly from TOE scores for assessment of the closed and open valve. In transitional phases (close-to-open and open-to-close) TOE performed significantly better when compared with static MDCT images, whereas no significant difference was present between cine-mode presentation of MDCT and TOE. Planimetric AVA measurements correlated significantly between TOE and MDCT (Pearson correlation coefficient, r = 0.96; P < 0.0001). Contrast media inflow-related and ECG gating related artifacts were rated as slightly compromising (scores 3.24 and 3.21).
  
  
  CONCLUSIONS
  Retrospectively ECG-gated MDCT offers a noninvasive, accurate, and dynamic imaging method for quantitative and qualitative evaluation of the normal aortic valve allowing determination of morphology and function throughout the cardiac cycle. Further studies regarding assessment of diseased valves are necessary.
authors.affiliation: Institute of Diagnostic Radiology, University Hospital Zurich, Switzerland.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Baumert
authors.forename: André
authors.initials: A
authors.lastname: Plass
authors.forename: Dominique
authors.initials: D
authors.lastname: Bettex
authors.forename: Hatem
authors.initials: H
authors.lastname: Alkadhi
authors.forename: Lotus
authors.initials: L
authors.lastname: Desbiolles
authors.forename: Simon
authors.initials: S
authors.lastname: Wildermuth
authors.forename: Borut
authors.initials: B
authors.lastname: Marincek
authors.forename: Thomas
authors.initials: T
authors.lastname: Boehm
mesh_terms: D000368:Aged; D000465:Algorithms; D019412:Anatomy, Cross-Sectional / Q000379:methods*; D001021:Aortic Valve / Q000000981:diagnostic imaging*; D001185:Artificial Intelligence; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011785:Quality Assurance, Health Care / Q000379:methods; D011856:Radiographic Image Enhancement / Q000379:methods; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000295:instrumentation* / Q000379:methods*; D014159:Transducers