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Aortic stenosis: evaluation with multidetector CT angiography and MR imaging.

Chun EJ, Choi SI, Lim C, Park KH, Chang HJ, Choi DJ, Kim DH, Lee W, Park JH - Korean J Radiol (2008 Sep-Oct)

Bottom Line: Aortic valvular stenosis (AS) is the most common valve disease which results in the need for a valve replacement.In this study, we briefly describe the usefulness and comparative merits of the MDCT and MRI for the evaluation of AS in terms of valvular morphology (as the causes of AS), quantification of aortic valve area, pressure gradient of flow (for assessment severity of AS), and the evaluation of the ascending aorta and cardiac function (as the secondary effects of AS).The familiarity with the MDCT and MRI features of AS is considered to be helpful for the accurate diagnosis and proper management of patients with a poor acoustic window.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Seoul National University Bundang Hospital, Gyeonggi-do, Korea.

ABSTRACT
Aortic valvular stenosis (AS) is the most common valve disease which results in the need for a valve replacement. Although a Doppler echocardiography is the current reference imaging method, the multidetector computerized tomograpghy (MDCT) and magnetic resonance imaging (MRI) have recently emerged as a promising method for noninvasive valve imaging. In this study, we briefly describe the usefulness and comparative merits of the MDCT and MRI for the evaluation of AS in terms of valvular morphology (as the causes of AS), quantification of aortic valve area, pressure gradient of flow (for assessment severity of AS), and the evaluation of the ascending aorta and cardiac function (as the secondary effects of AS). The familiarity with the MDCT and MRI features of AS is considered to be helpful for the accurate diagnosis and proper management of patients with a poor acoustic window.

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Related in: MedlinePlus

Thickened bicuspid valve with severe aortic stenosis. Thickened bicuspid valve with severe aortic stenosis from ECG-gated multidetector CT in systolic phase (A) and diastolic phase (B) is well correlated with surgical findings (C).
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Figure 4: Thickened bicuspid valve with severe aortic stenosis. Thickened bicuspid valve with severe aortic stenosis from ECG-gated multidetector CT in systolic phase (A) and diastolic phase (B) is well correlated with surgical findings (C).

Mentions: The morphology of the aortic valve, including aortic valve leaflets, free edges, and annuli, can be assessed in parallel and perpendicular planes at the mid-systolic phase (i.e., open valve) and at the mid-diastolic phase (i.e., closed valve) using multiplanar reformation and double-oblique reformations (Fig. 1) on an ECG-gated MDCT. The aortic valve was normally found to be tricuspid (composed of symmetric three leaflets) (Fig. 2). However, congenitally malformed valves such as bicuspid valves (Figs. 3, 4), unicuspid valves (Fig. 5), and quadricuspid valves (Fig. 6), are more predisposed to develop calcification, stenosis, and regurgitation. Because the abnormal architecture induces turbulent flow, it traumatizes the leaflets and leads to fibrosis, increased rigidity, and calcification of the leaflets, which ultimately results in the narrowing of the aortic orifice. An ECG-gated MDCT has the ability to accurately depict these morphologic abnormalities of the aortic valve (10-12).


Aortic stenosis: evaluation with multidetector CT angiography and MR imaging.

Chun EJ, Choi SI, Lim C, Park KH, Chang HJ, Choi DJ, Kim DH, Lee W, Park JH - Korean J Radiol (2008 Sep-Oct)

Thickened bicuspid valve with severe aortic stenosis. Thickened bicuspid valve with severe aortic stenosis from ECG-gated multidetector CT in systolic phase (A) and diastolic phase (B) is well correlated with surgical findings (C).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2627207&req=5

Figure 4: Thickened bicuspid valve with severe aortic stenosis. Thickened bicuspid valve with severe aortic stenosis from ECG-gated multidetector CT in systolic phase (A) and diastolic phase (B) is well correlated with surgical findings (C).
Mentions: The morphology of the aortic valve, including aortic valve leaflets, free edges, and annuli, can be assessed in parallel and perpendicular planes at the mid-systolic phase (i.e., open valve) and at the mid-diastolic phase (i.e., closed valve) using multiplanar reformation and double-oblique reformations (Fig. 1) on an ECG-gated MDCT. The aortic valve was normally found to be tricuspid (composed of symmetric three leaflets) (Fig. 2). However, congenitally malformed valves such as bicuspid valves (Figs. 3, 4), unicuspid valves (Fig. 5), and quadricuspid valves (Fig. 6), are more predisposed to develop calcification, stenosis, and regurgitation. Because the abnormal architecture induces turbulent flow, it traumatizes the leaflets and leads to fibrosis, increased rigidity, and calcification of the leaflets, which ultimately results in the narrowing of the aortic orifice. An ECG-gated MDCT has the ability to accurately depict these morphologic abnormalities of the aortic valve (10-12).

Bottom Line: Aortic valvular stenosis (AS) is the most common valve disease which results in the need for a valve replacement.In this study, we briefly describe the usefulness and comparative merits of the MDCT and MRI for the evaluation of AS in terms of valvular morphology (as the causes of AS), quantification of aortic valve area, pressure gradient of flow (for assessment severity of AS), and the evaluation of the ascending aorta and cardiac function (as the secondary effects of AS).The familiarity with the MDCT and MRI features of AS is considered to be helpful for the accurate diagnosis and proper management of patients with a poor acoustic window.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Seoul National University Bundang Hospital, Gyeonggi-do, Korea.

ABSTRACT
Aortic valvular stenosis (AS) is the most common valve disease which results in the need for a valve replacement. Although a Doppler echocardiography is the current reference imaging method, the multidetector computerized tomograpghy (MDCT) and magnetic resonance imaging (MRI) have recently emerged as a promising method for noninvasive valve imaging. In this study, we briefly describe the usefulness and comparative merits of the MDCT and MRI for the evaluation of AS in terms of valvular morphology (as the causes of AS), quantification of aortic valve area, pressure gradient of flow (for assessment severity of AS), and the evaluation of the ascending aorta and cardiac function (as the secondary effects of AS). The familiarity with the MDCT and MRI features of AS is considered to be helpful for the accurate diagnosis and proper management of patients with a poor acoustic window.

Show MeSH
Related in: MedlinePlus