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European Radiology
Published in: European Radiology 10/2011

Open Access 01-10-2011 | Cardiac

Multidetector CT imaging of mechanical prosthetic heart valves: quantification of artifacts with a pulsatile in-vitro model

Authors: Petr Symersky, Ricardo P. J. Budde, Paul Westers, Bas A. J. M. de Mol, Mathias Prokop

Published in: European Radiology | Issue 10/2011

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Abstract

Objectives

Multidetector computed tomography (MDCT) can detect the cause of prosthetic heart valve (PHV) dysfunction but is hampered by valve-induced artifacts. We quantified artifacts of four PHV using a pulsatile in-vitro model and assessed the relation to leaflet motion and valve design.

Methods

A Medtronic Hall tilting disc (MH), and Carbomedics (CM), St Jude (SJM), and ON-X bileaflet valves underwent CT in an in-vitro model using retrospective gating with a 64 detector CT system in stationary and pulsatile conditions. Artifacts and radiopaque component volumes were quantified with thresholds based on surrounding structures and valvular components.

Results

Hypodense artifacts volumes (mm3) were 1,029 ± 147, 535 ± 53, 371 ± 16, and 366 ± 18 for the SJM, MH, CM and ON-X valves (p < 0.001 except for the latter two valves p = 0.43). Hyperdense artifact volumes were 3,546 ± 141, 2,387 ± 103, 2,003 ± 102, and 3,033 ± 31 for the SJM, MH, CM and ON-X valve, respectively (all differences p < 0.001). Leaflet motion affected hypodense (F = 41.5, p < 0.001) and hyperdense artifacts (F = 53.7, p < 0.001). Closed and moving leaflets were associated with the least and the most artifacts respectively (p < 0.001, both artifact types).

Conclusion

Both valve design and leaflet motion affect PHV-induced artifacts. Best imaging results may be expected for the CM valve during phases in which the leaflets are closed.
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Metadata
Title
Multidetector CT imaging of mechanical prosthetic heart valves: quantification of artifacts with a pulsatile in-vitro model
Authors
Petr Symersky
Ricardo P. J. Budde
Paul Westers
Bas A. J. M. de Mol
Mathias Prokop
Publication date
01-10-2011
Publisher
Springer-Verlag
Published in
European Radiology / Issue 10/2011
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-011-2146-y

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