Skip to main content
SpringerLink
Log in

Morphology and beyond: CT of cardiac valves

  • Published:
Current Cardiovascular Imaging Reports Aims and scope Submit manuscript

Abstract

Multi-detector row CT has developed into a valuable tool for noninvasive imaging of the heart. The major indication of cardiac CT represents the diagnosis or exclusion of coronary artery disease. Owing to its cross-sectional nature, the same data obtained for the coronary arteries contain morpho-anatomical information about the cardiac chambers and valves. When scanning in the retrospectively electrocardiography-gated mode, data can be reconstructed in various phases of the cardiac cycle. This enables assessing the movement of the open and closed valves. When performing planimetric measurements of the valve opening and regurgitant orifice areas in case of stenotic and regurgitant valves, estimations of valvular function can be given that correlate well with the results from echocardiography. This article reviews the current evidence regarding the accuracy of CT for imaging the morphology and function of the cardiac valves.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References and Recommended Reading

  1. Bonow RO, Carabello BA, Kanu C, et al.: ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): developed in collaboration with the Society of Cardiovascular Anesthesiologists: endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons. Circulation 2006, 114:e84–e231.

    Article  PubMed  Google Scholar 

  2. Kanal E, Barkovich AJ, Bell C, et al.: ACR guidance document for safe MR practices: 2007. AJR Am J Roentgenol 2007, 188:1447–1474.

    Article  PubMed  Google Scholar 

  3. Hendel RC, Patel MR, Kramer CM, et al.: ACCF/ACR/ SCCT/SCMR/ASNC/NASCI/SCAI/SIR 2006 appropriateness criteria for cardiac computed tomography and cardiac magnetic resonance imaging: a report of the American College of Cardiology Foundation Quality Strategic Directions Committee Appropriateness Criteria Working Group, American College of Radiology, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, American Society of Nuclear Cardiology, North American Society for Cardiac Imaging, Society for Cardiovascular Angiography and Interventions, and Society of Interventional Radiology. J Am Coll Cardiol 2006, 48:1475–1497.

    Article  PubMed  Google Scholar 

  4. Alkadhi H, Scheffel H, Desbiolles L, et al.: Dual-source computed tomography coronary angiography: influence of obesity, calcium load, and heart rate on diagnostic accuracy. Eur Heart J 2008, 29:766–776.

    Article  PubMed  Google Scholar 

  5. Gilard M, Le Gal G, Cornily JC, et al.: Midterm prognosis of patients with suspected coronary artery disease and normal multislice computed tomographic findings: a prospective management outcome study. Arch Intern Med 2007, 167:1686–1689.

    Article  PubMed  Google Scholar 

  6. Flohr TG, McCollough CH, Bruder H, et al.: First performance evaluation of a dual-source CT (DSCT) system. Eur Radiol 2006, 16:256–268.

    Article  PubMed  Google Scholar 

  7. Scheffel H, Alkadhi H, Leschka S, et al.: Low-dose CT coronary angiography in the step-and-shoot mode: diagnostic performance. Heart 2008, 94:1132–1137.

    Article  PubMed  CAS  Google Scholar 

  8. Matt D, Scheffel H, Leschka S, et al.: Dual-source CT coronary angiography: image quality, mean heart rate, and heart rate variability. AJR Am J Roentgenol 2007, 189:567–573.

    Article  PubMed  Google Scholar 

  9. Anderson RH: Clinical anatomy of the aortic root. Heart 2000, 84:670–673.

    Article  PubMed  CAS  Google Scholar 

  10. Baumert B, Plass A, Bettex D, et al.: Dynamic cine mode imaging of the normal aortic valve using 16-channel multidetector row computed tomography. Invest Radiol 2005, 40:637–647.

    Article  PubMed  Google Scholar 

  11. Manghat NE, Rachapalli V, Van Lingen R, et al.: Imaging the heart valves using ECG-gated 64-detector row cardiac CT. Br J Radiol 2008, 81:275–290.

    Article  PubMed  CAS  Google Scholar 

  12. Morgan-Hughes GJ, Roobottom CA, Marshall AJ: Aortic valve imaging with computed tomography: a review. J Heart Valve Dis 2002, 11:604–611.

    PubMed  CAS  Google Scholar 

  13. Boxt LM: CT of valvular heart disease. Int J Cardiovasc Imaging 2005, 21:105–113.

    Article  PubMed  Google Scholar 

  14. Alkadhi H, Desbiolles L, Husmann L, et al.: Aortic regurgitation: assessment with 64-section CT. Radiology 2007, 245:111–121.

    Article  PubMed  Google Scholar 

  15. Alkadhi H, Leschka S, Hurlimann D, et al.: Fibroelastoma of the aortic valve. Evaluation with echocardiography and 64-slice CT. Herz 2005, 30:438.

    Article  PubMed  Google Scholar 

  16. Feuchtner GM, Stolzmann P, Dichtl W, et al.: Multislice computed tomography in infective endocarditis: comparison with transesophageal echocardiography and intraoperative findings. J Am Coll Cardiol 2008, In press.

  17. Juergens KU, Fischbach R: Left ventricular function studied with MDCT. Eur Radiol 2006, 16:342–357.

    Article  PubMed  Google Scholar 

  18. Ho SY: Anatomy of the mitral valve. Heart 2002, 88(Suppl 4):iv5–iv10.

    PubMed  Google Scholar 

  19. Alkadhi H, Bettex D, Wildermuth S, et al.: Dynamic cine imaging of the mitral valve with 16-MDCT: a feasibility study. AJR Am J Roentgenol 2005, 185:636–646.

    PubMed  Google Scholar 

  20. Alkadhi H, Wildermuth S, Bettex DA, et al.: Mitral regurgitation: quantification with 16-detector row CT—initial experience. Radiology 2006, 238:454–463.

    Article  PubMed  Google Scholar 

  21. Alkadhi H, Leschka S, Pretre R, et al.: Caseous calcification of the mitral annulus. J Thorac Cardiovasc Surg 2005, 129:1438–1440.

    Article  PubMed  Google Scholar 

  22. Ryan R, Abbara S, Colen RR, et al.: Cardiac valve disease: spectrum of findings on cardiac 64-MDCT. AJR Am J Roentgenol 2008, 190:W294–W303.

    Article  PubMed  Google Scholar 

  23. Mollet NR, Dymarkowski S, Bogaert J: MRI and CT revealing carcinoid heart disease. Eur Radiol 2003, 13(Suppl 6):L14–L18.

    Article  Google Scholar 

  24. Hwang YJ, Park CH, Jeon YB, Park KY: Severe pulmonary artery stenosis by a calcified pericardial ring. Eur J Cardiothorac Surg 2006, 29:619–621.

    Article  PubMed  Google Scholar 

  25. Koos R, Kuhl HP, Muhlenbruch G, et al.: Prevalence and clinical importance of aortic valve calcification detected incidentally on CT scans: comparison with echocardiography. Radiology 2006, 241:76–82.

    Article  PubMed  Google Scholar 

  26. Koos R, Mahnken AH, Sinha AM, et al.: Aortic valve calcification as a marker for aortic stenosis severity: assessment on 16-MDCT. AJR Am J Roentgenol 2004, 183:1813–1818.

    PubMed  Google Scholar 

  27. Feuchtner GM, Muller S, Grander W, et al.: Aortic valve calcification as quantified with multislice computed tomography predicts short-term clinical outcome in patients with asymptomatic aortic stenosis. J Heart Valve Dis 2006, 15:494–498.

    PubMed  Google Scholar 

  28. Messika-Zeitoun D, Aubry MC, Detaint D, et al.: Evaluation and clinical implications of aortic valve calcification measured by electron-beam computed tomography. Circulation 2004, 110:356–362.

    Article  PubMed  Google Scholar 

  29. Alkadhi H, Wildermuth S, Plass A, et al.: Aortic stenosis: comparative evaluation of 16-detector row CT and echocardiography. Radiology 2006, 240:47–55.

    Article  PubMed  Google Scholar 

  30. Abbara S, Pena AJ, Maurovich-Horvat P, et al.: Feasibility and optimization of aortic valve planimetry with MDCT. AJR Am J Roentgenol 2007, 188:356–360.

    Article  PubMed  Google Scholar 

  31. Bouvier E, Logeart D, Sablayrolles JL, et al.: Diagnosis of aortic valvular stenosis by multislice cardiac computed tomography. Eur Heart J 2006, 27:3033–3038.

    Article  PubMed  Google Scholar 

  32. Feuchtner GM, Dichtl W, Friedrich GJ, et al.: Multislice computed tomography for detection of patients with aortic valve stenosis and quantification of severity. J Am Coll Cardiol 2006, 47:1410–1417.

    Article  PubMed  Google Scholar 

  33. Feuchtner GM, Muller S, Bonatti J, et al.: Sixty-four slice CT evaluation of aortic stenosis using planimetry of the aortic valve area. AJR Am J Roentgenol 2007, 189:197–203.

    Article  PubMed  Google Scholar 

  34. Habis M, Daoud B, Roger VL, et al.: Comparison of 64-slice computed tomography planimetry and Doppler echocardiography in the assessment of aortic valve stenosis. J Heart Valve Dis 2007, 16:216–224.

    PubMed  Google Scholar 

  35. Laissy JP, Messika-Zeitoun D, Serfaty JM, et al.: Comprehensive evaluation of preoperative patients with aortic valve stenosis: usefulness of cardiac multidetector computed tomography. Heart 2007, 93:1121–1125.

    Article  PubMed  Google Scholar 

  36. Pouleur AC, le Polain de Waroux JB, Pasquet A, et al.: Aortic valve area assessment: multidetector CT compared with cine MR imaging and transthoracic and transesophageal echocardiography. Radiology 2007, 244:745–754.

    Article  PubMed  Google Scholar 

  37. Tanaka H, Shimada K, Yoshida K, et al.: The simultaneous assessment of aortic valve area and coronary artery stenosis using 16-slice multidetector-row computed tomography in patients with aortic stenosis comparison with echocardiography. Circ J 2007, 71:1593–1598.

    Article  PubMed  Google Scholar 

  38. Feuchtner GM, Dichtl W, Muller S, et al.: 64-MDCT for diagnosis of aortic regurgitation in patients referred to CT coronary angiography. AJR Am J Roentgenol 2008, 191:W1–W7.

    Article  PubMed  Google Scholar 

  39. Feuchtner GM, Dichtl W, Schachner T, et al.: Diagnostic performance of MDCT for detecting aortic valve regurgitation. AJR Am J Roentgenol 2006, 186:1676–1681.

    Article  PubMed  Google Scholar 

  40. Jassal DS, Shapiro MD, Neilan TG, et al.: 64-slice multidetector computed tomography (MDCT) for detection of aortic regurgitation and quantification of severity. Invest Radiol 2007, 42:507–512.

    Article  PubMed  Google Scholar 

  41. Messika-Zeitoun D, Serfaty JM, Laissy JP, et al.: Assessment of the mitral valve area in patients with mitral stenosis by multislice computed tomography. J Am Coll Cardiol 2006, 48:411–413.

    Article  PubMed  Google Scholar 

  42. Groves AM, Win T, Charman SC, et al.: Semi-quantitative assessment of tricuspid regurgitation on contrast-enhanced multidetector CT. Clin Radiol 2004, 59:715–719.

    Article  PubMed  CAS  Google Scholar 

  43. Yeh BM, Kurzman P, Foster E, et al.: Clinical relevance of retrograde inferior vena cava or hepatic vein opacification during contrast-enhanced CT. AJR Am J Roentgenol 2004, 183:1227–1232.

    PubMed  Google Scholar 

  44. Stolzmann P, Scheffel H, Trindade PT, et al.: Left ventricular and left atrial dimensions and volumes: comparison between dual-source CT and echocardiography. Invest Radiol 2008, 43:284–289.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Institute of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland

    Hatem Alkadhi

Authors
  1. Hatem Alkadhi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hatem Alkadhi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Alkadhi, H. Morphology and beyond: CT of cardiac valves. curr cardiovasc imaging rep 1, 141–148 (2008). https://doi.org/10.1007/s12410-008-0021-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12410-008-0021-2

Keywords

Search

Navigation