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

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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.

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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

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Acknowledgements

This work was supported by the Fonds National de la Recherche Scientifique of the Belgian Government (FNRS). Dr. Goffinet is aspirant of the Fonds National de la Recherche Scientifique of the Belgian Government.

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Authors and Affiliations

  1. Cardiology Division, Cliniques Universitaires St. Luc UCL, Av Hippocrate 10/2806, 1200, Woluwe St. Lambert, Belgium

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

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  1. Céline Goffinet
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  2. Valérie Kersten
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  3. Anne-Catherine Pouleur
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  8. Bernhard L. Gerber
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Correspondence to Bernhard L. Gerber.

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Goffinet, C., Kersten, V., Pouleur, AC. et al. Comprehensive assessment of the severity and mechanism of aortic regurgitation using multidetector CT and MR. Eur Radiol 20, 326–336 (2010). https://doi.org/10.1007/s00330-009-1544-x

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