Radiology: Volume 245: Number 1-October 2007
Hatem Alkadhi, MD Lotus Desbiolles, MD Lars Husmann, MD Andre Plass, MD Sebastian Leschka, MD Hans Scheffel, MD Robert Vachenauer, MD Tiziano Schepis, MD Oliver Gaemperli, MD Thomas G. FIohr, PhD Michele Genoni, MD Borut Marincek, MD Rolf Jenni, MD Philipp A. Kaufmann, MD Thomas Frauenfelder, MD
Purpose: To prospectively evaluate diagnostic accuracy of 64-section computed tomography (CT) for evaluation of aortic regurgitation (AR), with transthoracic echocardiography (TTE) as reference.
Materials and Methods: The institutional review hoard approved this study; written informed consent was obtained. Thirty patients (23 men, seven women; mean age, 56.6 years) with AH underwent TTE and retrospective electrocardiographically gated 64-section CT. CT data sets were reconstructed in 5% steps from 40% to 90% of R-R interval for analysis. Maximum regurgitant orifice area (ROA) in diastole was plani-metrically measured with CT, and measurements were compared with semiquantitative classification with TTE (Spearman rank order correlation coefficients). Receiver operating characteristic (ROC) curves were calculated for differentiation between degrees of AR with ROA measurements. Dimensions of the aortic root and left ventricular parameters were compared (Pearson correlation analy-sis).
Results: A significant correlation was observed between CT plani-metric size of ROA (mean, 62 mm2 ± 63 [standard devia-tion]; range, 6-224 mm2) and TTE classification of mild, moderate, and severe AR (r = 0.84, P < .001). With ROC analysis, discrimination between degrees of AR with CT was highly accurate when cutoff ROAs (25 mm2 and 75 mm2) were used. A significant correlation was observed between methods in dimensions of aortic annulus (mean, 29.0 mm ± 4.6), sinus of Valsalva (mean, 38.3 mm ± 8.6), and ascending aorta (mean, 37.2 mm ± 8.0); mean values were 27.4 mm ± 4:9 (r = 0.76, P < .001), 37.7 mm ±8.6 (r = 0.94, P < .001), and 38.2 mm ± 7.9 (r = 0.96, P < .001), respectively. Mean end-systolic volume (67 mL ± 38), end-diastolic volume (149 mL ± 48), and ejection fraction (57% ± 13) at CT correlated well with mean results at TTE (65 mL ± 36 \r = 0.96, P< .001], 140 mL ± 48 [r = 0.91, P< .001], 56% ± 13 [r = 0.98, P < .001], respectively).
Conclusion: Results of assessment of AR with 64-section CT arc similar to those with TTE.