Evaluation Of The Aortic Valve With DSCT

Objective:1.To observe the morphologic features and changes of motion and image quality of dynamic cine-mode imaging of the aortic valve with DSCT.2.The AVA was measured planimetrically and was compared between DSCT and TTE;To find out the impact of individual factors on the AVA.3.To evaluate diagnostic accuracy of DSCT for evaluation of AS and AR with TTE as reference.4. DSCT and TTE findings were compared two methods for measurements of differences in dimensions of aortic root.Material and method:1. DSCT and TTE examinations were performed on 125 patients with suspected of CHD with 72hours, Twenty date sets in 5% steps of the R-R interval were reconstructed,and date analysis was performed using a 4D software. Images reading was performed in the parallel and perpendicular planes in relation to the aortic ring for visual assessment of aortic valve morphology and motion. Evaluation image quality of aortic valve in cardiac cycle.2.The AVA was measured planimetrically and was compared between DSCT and TTE. To Analyze the impact of BMI,hight,weight,sex and age on the AVA.3.DSCT and TTE findings were compared two methods for detecting of differents in AS.4.Maximum ROA in diastole was planimetrically measured with DSCT,and measurements were compared with semiquantitative classification with TTE.5.Dimentions of the aortic root were compared.Results:1.27 patients with degenerative aortic valve disease were identified by DSCT; DSCT correctly identified 26 patients with AR.92.3% phases of the total 2500 phases in 125 patients can be evaluated,which 74%phases in the greade one. The best phase for assessing the open valve using DSCT was at 20% and the closed valve at 40%-95% of the cardiac cycle.2. Planimetric AVA measurements correlated significantly between DSCT and TTE(r=0.93), however,DSCT and TTE with a slight overestimation of AVA by DSCT(0.12±0.20cm2). The largest AVA was found at 10% during systole. There were no significant differences in the size of AVA and the different age and body weight (P>0.05). There were significant differences in the size of AVA based on different BMI and body height(P<0.05), and body height more impact on size of the AVA.3. The diagnostic accuracy of DSCT in detecting AS was as follows:sensitivity of 85.71%,specificity of 99.15%, positive predictive value(PPV) of 85.71%,negative predictive value(NPV) of 99.15%,and accuracy was 98.4%.4. The diagnostic accuracy of DSCT in detecting AR was as follows:sensitivity of 92%,specificity of 97%,positive predictive value(PPV) of 82.46%,negative predictive value(NPV) of 97.98%,and accuracy was 96%. Quantification of the ROA by DSCT was significantly correlated with the severity of AR by TTE(r=0.81).5. A significant correlation was observed between methods in dimensions of aortic annulus,sinus of Valsalva,and ascending aorta (r=0.87/0.91/0.92).Conclusion:1. DSCT allows accurate and dynamic visualization morphology and motion of aortic valve throughout the cardiac cycle.2.DSCT assessment AR is feasible and accurate.Such as that based on high NPV,DSCT can be used to "rule-out" AR.3. DSCT could achieve a comprehensive and exhaustive preoperative assessment of patients with AS or AR.