European Radiology

, Volume 20, Issue 2, pp 326–336

Comprehensive assessment of the severity and mechanism of aortic regurgitation using multidetector CT and MR

  • Céline Goffinet
  • Valérie Kersten
  • Anne-Catherine Pouleur
  • Jean-Benoit le Polain de Waroux
  • David Vancraeynest
  • Agnès Pasquet
  • Jean-Louis Vanoverschelde
  • Bernhard L. Gerber
Cardiac

DOI: 10.1007/s00330-009-1544-x

Cite this article as:
Goffinet, C., Kersten, V., Pouleur, AC. et al. Eur Radiol (2010) 20: 326. doi:10.1007/s00330-009-1544-x

Abstract

Recent studies have suggested that both cardiac magnetic resonance (MR) and multidetector computed tomography (MDCT) can quantify aortic regurgitation (AR) by planimetry of the anatomical regurgitant orifice (ARO). However, this measurement was not compared with quantitative assessment of AR such as the effective regurgitant orifice (ERO) by proximal isosurface area (PISA) transthoracic echocardiography (TTE) or phase contrast MR. In 42 patients (34 men, age 54 ± 11 years) we compared planimetered ARO by MDCT and MR with ERO and regurgitant volume by PISA TTE and phase contrast MR. ARO by MDCT (r = 0.87, p < 0.001) and MR (r = 0.81, p < 0.001) correlated highly with ERO by TTE. However, ARO by MDCT (27 ± 15 mm2, p < 0.001), but not by MR (23 ± 13 mm2, p = 0.58), were larger than PISA ERO (22 ± 11 mm2). ARO by MDCT (r = 0.78, p < 0.001; r = 0.85, p < 0.001) and MR (r = 0.85, p < 0.001; r = 0.87 p < 0.001) correlated well with regurgitant volume by PISA and phase contrast MR. Both MDCT (к = 0.80, p < 0.001) and MR (к = 0.84, p < 0.001) demonstrated excellent agreement in correctly assessing the mechanisms of AR, i.e. aortic root dilatation (type I), cusp prolapse (type II) and restrictive cusp motion (type III), using surgical inspection as a reference. Measurement of ARO by both MDCT and MR allows accurate quantitative assessment of AR. Both techniques can also accurately determine the mechanism of AR.

Keywords

Multidetector computed tomographyCardiac magnetic resonanceSurgeryValvesAortic insufficiency

Abbreviations

AR

aortic regurgitation

ARO

anatomical regurgitant orifice

AUC

area under the ROC curve

ERO

efficient regurgitant orifice

MR

cardiac magnetic resonance

MDCT

multidetector row computed tomography

PISA

proximal isosurface area

ROC

receiver operating characteristics

TTE

transthoracic echocardiography

TEE

transoesophageal echocardiography

Copyright information

© European Society of Radiology 2009

Authors and Affiliations

  • Céline Goffinet
    • 1
  • Valérie Kersten
    • 1
  • Anne-Catherine Pouleur
    • 1
  • Jean-Benoit le Polain de Waroux
    • 1
  • David Vancraeynest
    • 1
  • Agnès Pasquet
    • 1
  • Jean-Louis Vanoverschelde
    • 1
  • Bernhard L. Gerber
    • 1
  1. 1.Cardiology DivisionCliniques Universitaires St. Luc UCLWoluwe St. LambertBelgium