Imaging Pearls ❯ Cardiac ❯ Coronary CTA
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- "Aortic valve planimetry is best performed at phase starts of 50-100 milliseconds after the R peak because the area of the aortic opening is widest and image quality is best at that phase."
Feasibility and Optimization of Aortic Valve Planimetry with MDCT
Abbar S et al.
AJR 2007; 188:356-360
- "We show in this study that MDCT can potentially be used to evaluate stenotic aortic valves, which often coexist with coronary artery disease. Additional studies need to be performed to further clarify the accuracy of the technique and its role in the clinicaldecision making process."
Feasibility and Optimization of Aortic Valve Planimetry with MDCT
Abbar S et al.
AJR 2007; 188:356-360
- " Our preliminary results suggest that MDCT is a promising technique for functional evaluation of bileaflet mechanical valves, allowing reliable measurements of opening and closing leaflet angles."
The Role of ECG-Gated MDCT in the Evaluation of Aortic and Mitral Mechanical Valves: Initial Experience
Konen E et al.
AJR 2008; 191:26-31
- " Our preliminary results suggest that MDCT is a promising technique for functional evaluation of bileaflet mechanical valves, allowing reliable measurements of opening and closing leaflet angles. However, the role of MDCT in the evaluation of single leaflet valves may be limited."
The Role of ECG-Gated MDCT in the Evaluation of Aortic and Mitral Mechanical Valves: Initial Experience
Konen E et al.
AJR 2008; 191:26-31
- Cardiac Tumors:Facts
- Most common primary cardiac tumor is myxoma
- Myxomas are most common in the left atrium in or near the foramen ovale
- Benign tumors make up 77% of primary cardiac tumors
- Pericardial tumors are more common than intracardiac tumors
- Bicuspid Aortic Valve:Facts
- Incidence of 0.4-2.2%
- More common on Turner’s syndrome, coarctation of the aorta and VSD
- Leads to early valve calcification and aortic stenosis with dilated ascending aorta
- " Four dimensional cardiac CT will make a major contribution to harnessing the full morphologic and functional potential of high quality MDCT data acquired form a single cardiac cycle."
Four-Dimensional Imaging of the Heart Based on Near Isotrophic MDCT Datasets
Lawler LP, Ney DR, Pannu HK, Fishman EK
AJR 2005 Mar;184(3):774-776
- " Four dimensional cardiac CT in its current form provides an overview of global and regional myocardial or valvular motion and volume changes during the cardiac cycle."
Four-Dimensional Imaging of the Heart Based on Near Isotrophic MDCT Datasets
Lawler LP, Ney DR, Pannu HK, Fishman EK
AJR 2005 Mar;184(3):774-776
- " Virtually all patients with aortic valve calcification had coronary calcification, potentially explaining the coronary risk associated with aortic valve calcification. There is substantially parallel development between rates of progression of EBT-assessed aortic valve calcification and coronary calcification."
Association Between Progression of Aortic Valve Calcification and Coronary Calcification
Takasu J et al.
Acad Radiol 2005; 12:298-304
- "Noninvasive cine-mode imaging of the mitral valve using retrospective ECG-gated MDCT is feasible and allows accurate visualization of the moving valve. Perpendicular long axis reconstructions yield images of superior quality when compared with the short axis reconstructions and enable a determination of its functional morphology."
Dynamic Cine Imaging of the Mitral Valve with 16-MDCT: A Feasibility Study Alkadhi H et al.
AJR 2005; 185 636-646
- What is the significance of a bicuspid valve?
- Degenerative calcification occurs in all aortic valves over time and aortic leaflet thickening and aortic stenosis occur in 26% and 2% of the population by age 90. With bicuspid valves the same process occurs but 2-3 decades earlier
- Bicuspid Aortic Valve: Facts
- 0.5-1% of population has a bicuspid valve
- Key finding is earlier and increased frequency of aortic valve calcification
- Sinus of Valsalva Aneurysm: Facts
- Due to trauma, infective endocarditis, or congenital causes
- Involvement of the non-coronary cusp is most common
- Patients present with chest pain, conduction abnormalities and aortic insufficiency
- "Once thought to be the domain of echocardiography and MRI, aortic valvular disease can often be assessed with current CT technology (16 MDCT)."
MDCT Evaluation of Aortic Valvular Disease
Gilkeson RC et al.
AJR 2006;186:350-360.
- "The severity of aortic valve calcifications on chest CT, as assessed either subjectively or objectively, correlated with increased pressure gradients across the aortic valve, particularly for calcification of the peripheral left posterior commissure and the central left-right commissure."
Aortic Valve Calcification as an Incidental Finding at CT of the Elderly:Severity and Location as predictors of Aortic Stenosis
Liu F et al.
AJR 2006; 186:342-349.
- "Visualization of the aortic valve and valvular motion during the cardiac cycle is feasible on CT studies performed for coronary angiography. CT has a potential role in the assessment of aortic valvular pathology."
Gated cardiac imaging of the aortic valve on 64-slice multidetector row computed tomography: preliminary observations
Pannu HK, Jacobs JE, Lai S, Fishman EK
J Comput Assist Tomogr 2006 May-Jun; 30(3):443-446.