Chronic mitral regurgitation detected on cardiac MDCT: differentiation between functional and valvular aetiologies.

Hdl Handle:
http://hdl.handle.net/10147/207660
Title:
Chronic mitral regurgitation detected on cardiac MDCT: differentiation between functional and valvular aetiologies.
Authors:
Killeen, Ronan P; Arnous, Samer; Martos, Ramon; Abbara, Suhny; Quinn, Martin; Dodd, Jonathan D
Affiliation:
Department of Radiology, St. Vincent's University Hospital, Dublin, Ireland.
Citation:
Eur Radiol. 2010 Aug;20(8):1886-95. Epub 2010 Mar 23.
Journal:
European radiology
Issue Date:
1-Feb-2012
URI:
http://hdl.handle.net/10147/207660
DOI:
10.1007/s00330-010-1760-4
PubMed ID:
20309557
Abstract:
OBJECTIVE: To determine whether cardiac computed tomography (MDCT) can differentiate between functional and valvular aetiologies of chronic mitral regurgitation (MR) compared with echocardiography (TTE). METHODS: Twenty-seven patients with functional or valvular MR diagnosed by TTE and 19 controls prospectively underwent cardiac MDCT. The morphological appearance of the mitral valve (MV) leaflets, MV geometry, MV leaflet angle, left ventricular (LV) sphericity and global/regional wall motion were analysed. The coronary arteries were evaluated for obstructive atherosclerosis. RESULTS: All control and MR cases were correctly identified by MDCT. Significant differences were detected between valvular and control groups for anterior leaflet length (30 +/- 7 mm vs. 22 +/- 4 mm, P < 0.02) and thickness (3.0 +/- 1 mm vs. 2.2 +/- 1 mm, P < 0.01). High-grade coronary stenosis was detected in all patients with functional MR compared with no controls (P < 0.001). Significant differences in those with/without MV prolapse were detected in MV tent area (-1.0 +/- 0.6 mm vs. 1.3 +/- 0.9 mm, P < 0.0001) and MV tent height (-0.7 +/- 0.3 mm vs. 0.8 +/- 0.8 mm, P < 0.0001). Posterior leaflet angle was significantly greater for functional MR (37.9 +/- 19.1 degrees vs. 22.9 +/- 14 degrees , P < 0.018) and less for valvular MR (0.6 +/- 35.5 degrees vs. 22.9 +/- 14 degrees, P < 0.017). Sensitivity, specificity, and positive and negative predictive values of MDCT were 100%, 95%, 96% and 100%. CONCLUSION: Cardiac MDCT allows the differentiation between functional and valvular causes of MR.
Language:
eng
MeSH:
Aged; Aged, 80 and over; Chronic Disease; Diagnosis, Differential; Echocardiography; Female; Humans; Male; Middle Aged; Mitral Valve Insufficiency/classification/*etiology/*radiography/ultrasonography; Reproducibility of Results; Sensitivity and Specificity; Tomography, X-Ray Computed/*methods; Ventricular Dysfunction, Left/*complications/*radiography/ultrasonography
ISSN:
1432-1084 (Electronic); 0938-7994 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorKilleen, Ronan Pen_GB
dc.contributor.authorArnous, Sameren_GB
dc.contributor.authorMartos, Ramonen_GB
dc.contributor.authorAbbara, Suhnyen_GB
dc.contributor.authorQuinn, Martinen_GB
dc.contributor.authorDodd, Jonathan Den_GB
dc.date.accessioned2012-02-01T10:34:14Z-
dc.date.available2012-02-01T10:34:14Z-
dc.date.issued2012-02-01T10:34:14Z-
dc.identifier.citationEur Radiol. 2010 Aug;20(8):1886-95. Epub 2010 Mar 23.en_GB
dc.identifier.issn1432-1084 (Electronic)en_GB
dc.identifier.issn0938-7994 (Linking)en_GB
dc.identifier.pmid20309557en_GB
dc.identifier.doi10.1007/s00330-010-1760-4en_GB
dc.identifier.urihttp://hdl.handle.net/10147/207660-
dc.description.abstractOBJECTIVE: To determine whether cardiac computed tomography (MDCT) can differentiate between functional and valvular aetiologies of chronic mitral regurgitation (MR) compared with echocardiography (TTE). METHODS: Twenty-seven patients with functional or valvular MR diagnosed by TTE and 19 controls prospectively underwent cardiac MDCT. The morphological appearance of the mitral valve (MV) leaflets, MV geometry, MV leaflet angle, left ventricular (LV) sphericity and global/regional wall motion were analysed. The coronary arteries were evaluated for obstructive atherosclerosis. RESULTS: All control and MR cases were correctly identified by MDCT. Significant differences were detected between valvular and control groups for anterior leaflet length (30 +/- 7 mm vs. 22 +/- 4 mm, P < 0.02) and thickness (3.0 +/- 1 mm vs. 2.2 +/- 1 mm, P < 0.01). High-grade coronary stenosis was detected in all patients with functional MR compared with no controls (P < 0.001). Significant differences in those with/without MV prolapse were detected in MV tent area (-1.0 +/- 0.6 mm vs. 1.3 +/- 0.9 mm, P < 0.0001) and MV tent height (-0.7 +/- 0.3 mm vs. 0.8 +/- 0.8 mm, P < 0.0001). Posterior leaflet angle was significantly greater for functional MR (37.9 +/- 19.1 degrees vs. 22.9 +/- 14 degrees , P < 0.018) and less for valvular MR (0.6 +/- 35.5 degrees vs. 22.9 +/- 14 degrees, P < 0.017). Sensitivity, specificity, and positive and negative predictive values of MDCT were 100%, 95%, 96% and 100%. CONCLUSION: Cardiac MDCT allows the differentiation between functional and valvular causes of MR.en_GB
dc.language.isoengen_GB
dc.subject.meshAgeden_GB
dc.subject.meshAged, 80 and overen_GB
dc.subject.meshChronic Diseaseen_GB
dc.subject.meshDiagnosis, Differentialen_GB
dc.subject.meshEchocardiographyen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshHumansen_GB
dc.subject.meshMaleen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.meshMitral Valve Insufficiency/classification/*etiology/*radiography/ultrasonographyen_GB
dc.subject.meshReproducibility of Resultsen_GB
dc.subject.meshSensitivity and Specificityen_GB
dc.subject.meshTomography, X-Ray Computed/*methodsen_GB
dc.subject.meshVentricular Dysfunction, Left/*complications/*radiography/ultrasonographyen_GB
dc.titleChronic mitral regurgitation detected on cardiac MDCT: differentiation between functional and valvular aetiologies.en_GB
dc.contributor.departmentDepartment of Radiology, St. Vincent's University Hospital, Dublin, Ireland.en_GB
dc.identifier.journalEuropean radiologyen_GB
dc.description.provinceLeinster-

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