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Iterative reconstruction improves evaluation of native aortic and mitral valves by retrospectively ECG-gated thoracoabdominal CTA

  • Computed Tomography
  • Published:
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Abstract

Objectives

To compare native aortic (AV) and mitral valve (MV) image quality on limited-dose retrospectively ECG-gated CTA of the thoracoabdominal aorta reconstructed with iterative reconstruction (IR) and filtered back projection (FBP).

Methods

Fifty patients underwent routine care retrospectively ECG-gated thoracoabdominal limited-dose 256-slice CTA. At 30 % (systole) and 75 % (diastole) of the R-R interval AV and MV were reconstructed using FBP and IR. Objective image quality [density and noise (SD of density measurement)] was measured. Two independent observers scored subjective valve image quality using four-point Likert scales.

Results

IR significantly decreased image noise, but did not alter the aorta and interventricular septum density. Interobserver variability was moderate to good. Valve image quality was scored at least moderate in most cases. IR scored one or two Likert scale points higher than FBP in 10 (first observer) and 27 (second observer) scores. Conversely, IR scored one Likert scale point lower than FBP in 1 (first observer) and 4 (second observer) scores.

Conclusions

Limited-dose retrospectively ECG-gated thoracoabdominal CTA enables moderate to excellent evaluation of AV and MV in most patients, in addition to the primary diagnostic question. Image quality is further improved by IR.

Key Points

• Thoracoabdominal computed tomographic angiography demonstrates both the aortic and mitral valves.

• Iterative reconstruction decreases image noise and increases the SNR/CNR of thoracoabdominal CTA.

• Limited-dose retrospectively gated CTA enables moderate–excellent left-sided valvular evaluation.

• Iterative CT image reconstruction improves subjective native aortic and mitral valvular evaluation.

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Abbreviations

AV:

Aortic valve

CNR:

Contrast-to-noise ratio

CTA:

Computed tomography angiography

CTDIvol :

Volume CT dose index

DLP:

Dose–length product

ED:

Effective dose

FBP:

Filtered back projection

HU:

Hounsfield units

IR:

Iterative reconstruction

MV:

Mitral valve

SD:

Standard deviation

SNR:

Signal-to-noise ratio

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Acknowledgements

We would like to thank Robert Valkenburg, Anne Manders, Jamal Moumni and Karin Thijn for technical assistance.

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Authors and Affiliations

  1. Department of Radiology, Utrecht University Medical Center, P.O. Box 85500, E01.132, 3508 GA, Utrecht, The Netherlands

    Martin J. Willemink, Jesse Habets, Pim A. de Jong, Arnold M. R. Schilham, Willem P. Th. M. Mali, Tim Leiner & Ricardo P. J. Budde

  2. Department of Radiology, Gelre Hospital, Apeldoorn, The Netherlands

    Ricardo P. J. Budde

Authors
  1. Martin J. Willemink
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  2. Jesse Habets
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  3. Pim A. de Jong
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  4. Arnold M. R. Schilham
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  5. Willem P. Th. M. Mali
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  6. Tim Leiner
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  7. Ricardo P. J. Budde
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Correspondence to Martin J. Willemink.

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Willemink, M.J., Habets, J., de Jong, P.A. et al. Iterative reconstruction improves evaluation of native aortic and mitral valves by retrospectively ECG-gated thoracoabdominal CTA. Eur Radiol 23, 968–974 (2013). https://doi.org/10.1007/s00330-012-2673-1

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  • DOI: https://doi.org/10.1007/s00330-012-2673-1

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