Multislice computed tomography for detection of patients with aortic valve stenosis and quantification of severity.
OBJECTIVE
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.
Feuchtner
Gudrun M
GM
Clinical Department of Radiology II, Innsbruck Medical University, Innsbruck, Austria. Gudrun.Feuchtner@uibk.ac.at
Dichtl
Wolfgang
W
Friedrich
Guy J
GJ
Frick
Mathias
M
Alber
Hannes
H
Schachner
Thomas
T
Bonatti
Johannes
J
Mallouhi
Ammar
A
Frede
Thomas
T
Pachinger
Otmar
O
zur Nedden
Dieter
D
Müller
Silvana
S
D000368:Aged; D001021:Aortic Valve / Q000000981:diagnostic imaging; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging*; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed / Q000379:methods* / Q000592:standards