Key result
Planimetric measurement of the aortic regurgitant orifice area using MDCT distinguished severe aortic regurgitation from mild-to-moderate cases with 85% sensitivity and 82% specificity (AUC 0.91).
Why the study?
Does planimetric measurement of the aortic regurgitant orifice area using MDCT accurately evaluate the severity of aortic regurgitation compared to echocardiography in patients with aortic regurgitation?
Cross-Sectional (n=45)
No
Does planimetric measurement of the aortic regurgitant orifice area using MDCT accurately evaluate the severity of aortic regurgitation compared to echocardiography in patients with aortic regurgitation?
Planimetric measurement of the aortic regurgitant orifice area using MDCT is a feasible and accurate alternative for quantitatively evaluating the severity of aortic regurgitation, particularly when echocardiography is limited.
MDCT planimetry may complement echocardiography for AR grading when echo is limited; leaves open prospective outcome validation.
OBJECTIVE: This study compared the area of the regurgitant orifice, as measured by the use of multidetector-row CT (MDCT), with the severity of aortic regurgitation (AR) as determined by the use of echocardiography for AR. MATERIALS AND METHODS: In this study, 45 AR patients underwent electrocardiography-gated 40-slice or 64-slice MDCT and transthoracic or transesophageal echocardiography. We reconstructed CT data sets during mid-systolic to enddiastolic phases in 10% steps (20% and 35-95% of the R-R interval), planimetrically measuring the abnormally opened aortic valve area during diastole on CT reformatted images and comparing the area of the aortic regurgitant orifice (ARO) so measured with the severity of AR, as determined by echocardiography. RESULTS: In the 14 patients found to have mild AR, the ARO area was 0.18+/-0.13 cm(2) (range, 0.04-0.54 cm(2)). In the 15 moderate AR patients, the ARO area was 0.36 +/- 0.23 cm(2) (range, 0.09-0.81 cm(2)). In the 16 severe AR patients, the ARO area was 1.00 +/- 0.51 cm(2) (range, 0.23-1.84 cm(2)). Receiver-operator characteristic curve analysis determined a sensitivity of 85% and a specificity of 82%, for a cutoff of 0.47 cm(2), to distinguish severe AR from less than severe AR with the use of CT (area under the curve = 0.91; 95% confidence interval, 0.84-1.00; p < 0.001). CONCLUSION: Planimetric measurement of the ARO area using MDCT is useful for the quantitative evaluation of the severity of aortic regurgitation.
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Jeon et al. (2010) conducted a cross-sectional in Aortic regurgitation (n=45). Multidetector-row CT (MDCT) vs. Echocardiography was evaluated on Distinguishing severe aortic regurgitation from less than severe aortic regurgitation (AUC 0.91, 95% CI 0.84-1.00, p=<0.001). Planimetric measurement of the aortic regurgitant orifice area using MDCT distinguished severe aortic regurgitation from mild-to-moderate cases with 85% sensitivity and 82% specificity (AUC 0.91).
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