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European Radiology
Published in: European Radiology 8/2010

01-08-2010 | Computed Tomography

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

Authors: Ronan P. Killeen, Samer Arnous, Ramon Martos, Suhny Abbara, Martin Quinn, Jonathan D. Dodd

Published in: European Radiology | Issue 8/2010

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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° vs. 22.9 ± 14°, P < 0.018) and less for valvular MR (0.6 ± 35.5° vs. 22.9 ± 14°, 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.
Appendix
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Metadata
Title
Chronic mitral regurgitation detected on cardiac MDCT: differentiation between functional and valvular aetiologies
Authors
Ronan P. Killeen
Samer Arnous
Ramon Martos
Suhny Abbara
Martin Quinn
Jonathan D. Dodd
Publication date
01-08-2010
Publisher
Springer-Verlag
Published in
European Radiology / Issue 8/2010
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-010-1760-4

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