title: Evaluation of aortic valve stenosis by cardiac multislice computed tomography compared with echocardiography: a systematic review and meta-analysis.
abstract: OBJECTIVE
  It has not yet been established whether multi-slice computed tomography (MSCT) is reliable for the quantification of aortic valve area (AVA) in patients with aortic valve stenosis (AVS) and simultaneously for assessment of the coronary anatomy. The study aim, via a systematic literature review and meta-analysis, was to explore whether MSCT is a reliable method for AVA quantification, and simultaneously to assess the coronary anatomy in patients with AVS.
  
  
  METHODS
  A comprehensive systematic literature search and meta-analysis was conducted that included 14 studies totaling 470 patients. The meta-analysis was carried out to examine the reliability of MSCT compared to transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE). Seven studies including 266 patients with AVS were also eligible for a secondary analysis to compare the accuracy of MSCT with invasive coronary angiography.
  
  
  RESULTS
  The AVA was measured by MSCT and TTE in all 14 studies, and by TEE in four studies. The results of the meta-analyses showed that planimetry by MSCT overestimated the AVA, with a bias of 0.08 (95% CI 0.04, 0.13) cm2) (p = 0.0001) compared to TTE. The MSCT measurement was concordant with planimetry by TEE, with a small bias of -0.02 (95% CI -0.16, 0.11) cm2 (p = 0.71). MSCT, when compared to invasive angiography for the detection of significant coronary stenosis, showed sensitivity, specificity and diagnostic odds ratio of 95.5% (95% CI 88-99), 81% (95% CI 75-86)%, and 53 (95% CI 19-147), respectively.
  
  
  CONCLUSIONS
  MSCT is a reliable method for the quantification of AVA, and represents a promising technique for the combined evaluation of aortic valve morphology and coronary artery disease.
authors.affiliation: Division of Cardiology, Department of Medicine, Glostrup University Hospital, Copenhagen, Denmark. jawab@dadlnet.dk
authors.forename: Jawdat
authors.initials: J
authors.lastname: Abdulla
authors.forename: Jacob
authors.initials: J
authors.lastname: Sivertsen
authors.forename: Klaus Fuglsang
authors.initials: KF
authors.lastname: Kofoed
authors.forename: Hatem
authors.initials: H
authors.lastname: Alkadhi
authors.forename: Troy
authors.initials: T
authors.lastname: LaBounty
authors.forename: Steen Z
authors.initials: SZ
authors.lastname: Abildstrom
authors.forename: Lars
authors.initials: L
authors.lastname: Kober
authors.forename: Erik
authors.initials: E
authors.lastname: Christensen
authors.forename: Christian
authors.initials: C
authors.lastname: Torp-Pedersen
mesh_terms: D000792:Angiography; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging*; D004452:Echocardiography; D006801:Humans; D014057:Tomography, X-Ray Computed