Imaging the heart valves using ECG-gated 64-detector row cardiac CT

Abstract

Multi-detector row cardiac CT imaging demonstrates clinical usefulness in valvular heart disease, for which CT has not been traditionally used. Electrocardiographic (ECG)-gated CT coronary angiography also has an established clinical role with an increasingly solid evidence base, and the same data set in these patients also provides valuable information about chamber and valvular structure and function; this information should also be considered when interpreting cardiac CT and non-ECG gated thoracic imaging. Although true flow data cannot be achieved using CT, as with echocardiography and MRI, there are a number of imaging features that may be used when interpreting and inferring valve pathology. This article discusses the role of currently available imaging modalities and the rationale for cardiac CT, while focusing on the CT interpretation of valvular heart disease with respect to the relevant pathophysiology and management options that have importance to the radiologist. A suggested method of post-processing image review is provided with reference to a variety of normal and pathological pictorial illustrations.

Advanced Imaging of Athletes

“…80 CCT has produced equal precision as CMR for diagnosis along with identification of important related conditions such as aortic root diameter. 81 …”

The optimal use of cardiac imaging in the quantification of carcinoid heart disease

“…However, the introduction of multi-row detector CT has dramatically improved spatial resolution, enabling an in-depth assessment of the right heart chambers and valves, which are often difficult to assess using TTE. However, this modality is not superior to TTE with regard to quantification of haemodynamics (valvular regurgitation or pulmonary artery pressure; Manghat et al 2008), and the limited temporal resolution of cardiac CT can limit appreciation of valve motion.…”

Morphology and beyond: CT of cardiac valves

“…2). Both reconstructions parallel and perpendicular to the aortic annulus are useful for a comprehensive morphologic assessment of the aortic valve and root [10][11][12].…”

“…Long-and short-axis reconstructions perpendicular and parallel to the mitral annulus reconstructed during mid-diastole are most helpful in evaluating the morphology of the mitral valve components [11]. The assessment of the tendinous cords, which are small, variable in number and orientation, and move rapidly [18], often is problematic even when using recent CT scanner generations [20].…”