Accurate measurement of mitral annular dimensions by echocardiography: importance of correctly aligned imaging planes and anatomic landmarks.
BACKGROUND
Mitral annular (MA) dimensions obtained by traditional two-dimensional echocardiography are poorly standardized and do not adhere to anatomic principles. Correct anatomic imaging planes of the anterior-posterior (AP) and commissure-commissure (CC) axes of the mitral annulus were compared with the traditional method and correlated with cardiac computed tomography (CT).


METHODS
Seventeen subjects underwent traditional and correct anatomic imaging planes echocardiography and cardiac CT. The traditional method was obtained in the parasternal long-axis and apical 4-chamber views. Correct anatomic imaging planes were obtained in the apical long-axis view. The traditional and correct anatomic images planes methods were correlated with cardiac CT.


RESULTS
The traditional method of MA measurement correlated poorly with cardiac CT (AP axis: r = 0.13; CC axis: r = 0.02). The correct anatomic imaging planes method of MA measurement correlated very well with cardiac CT (AP axis: r = 0.96; CC axis: r = 0.91) (P < .05).


CONCLUSIONS
The correct anatomic imaging planes method provides accurate measurement of the AP and CC axes of the mitral annulus by adhering to geometric and anatomic principles.
Loma Linda University School of Medicine, Loma Linda, CA, USA. gary.foster2@va.gov
Gary P
GP
Foster
Adam K
AK
Dunn
Selwin
S
Abraham
Naser
N
Ahmadi
Guilda
G
Sarraf
D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity