title: Characterization of mitral valve prolapse with cardiac computed tomography: comparison to echocardiographic and intraoperative findings.
abstract: A single imaging modality that can accurately assess both coronary anatomy and mitral valve (MV) anatomy prior to surgery may be desirable. We sought to determine the diagnostic accuracy of cardiac computed tomography (CT) to detect and characterize mitral valve prolapse (MVP) compared to echocardiography. Consecutive patients referred for 'single-source' cardiac CT for investigation prior to non-coronary cardiac sugery were identified. MV anatomy was assessed for MVP and results were compared to echocardiography and to intra-operative visual assessment of the MV. Comparison between the three modalities was performed at the per-patient, per-leaflet and per-scallop levels. A total of 67 consecutive patients that were referred for Cardiac CT prior to non-coronary cardiac surgery and were prospectively recruited into a Cardiac CT registry. Of these, 65 patients underwent cardiac surgery. 63 patients had echocardiography and 32 patients had intra-operative visual assessment of the mitral valve. Compared to echocardiography, cardiac CT had excellent sensitivity (92.6%) and specificity (97.1%) for the detection of any MVP, but had poor sensitivity (68.5%) for the detection of individual prolapsing scallop. Compared to intra-operative visual assessment of the prolapsing scallop, both cardiac CT and echocardiography had low sensitivity (58.1 and 78.1%, respectively). Cardiac CT was able to identify patients with MVP but had difficulty identifying the prolapsed scallops compared to echocardiography. Single-source CT may not be ready for characterization of individual mitral valve scallops.
authors: Division of Cardiology, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, K1Y 4W7, Canada.
authors: Nina
authors: N
authors: Ghosh
authors: Haliah
authors: H
authors: Al-Shehri
authors: Kwan
authors: K
authors: Chan
authors: Thierry
authors: T
authors: Mesana
authors: Vincent
authors: V
authors: Chan
authors: Li
authors: L
authors: Chen
authors: Yeung
authors: Y
authors: Yam
authors: Benjamin J W
authors: BJ
authors: Chow
references: Am J Cardiol. 1991 Jun 1;67(15):1251-5
references: 2035450
references: Circulation. 1995 Feb 15;91(4):1022-8
references: 7850937
references: Radiology. 2006 Feb;238(2):454-63
references: 16371578
references: Circ Cardiovasc Imaging. 2009 Jan;2(1):16-23
references: 19808560
references: Circulation. 2008 Dec 9;118(24):2662-6
references: 19005092
references: Int J Cardiol. 2005 Jun 8;101(3):371-6
references: 15907403
references: J Thorac Imaging. 2010 Feb;25(1):76-85
references: 20160607
references: J Am Coll Cardiol. 2010 Mar 9;55(10):1017-28
references: 20202518
references: Eur Radiol. 2010 Aug;20(8):1886-95
references: 20309557
references: Int J Cardiovasc Imaging. 2008 Mar;24(3):327-9
references: 17909982
references: J Am Soc Echocardiogr. 2002 Mar;15(3):275-90
references: 11875394
references: J Am Coll Cardiol. 1999 Jun;33(7):2092-197
references: 10362225
references: AJR Am J Roentgenol. 2010 Mar;194(3):579-84
references: 20173131
references: J Thorac Cardiovasc Surg. 1983 Sep;86(3):323-37
references: 6887954
references: Circulation. 1981 Aug;64(2):360-7
references: 7249303
references: N Engl J Med. 1979 Jun 14;300(24):1350-8
references: 440357
references: J Am Coll Cardiol. 2005 Jul 19;46(2):302-9
references: 16022959
references: Am J Cardiol. 1995 Mar 1;75(7):489-93
references: 7863995
references: Radiology. 2010 Feb;254(2):374-83
references: 20093510
references: Int J Cardiovasc Imaging. 2005 Feb;21(1):105-13
references: 15915944