Detection of Aortic Regurgitation with 64-slice Multidetector Computed Tomography (MDCT)

Rationale and Objectives

To determine the diagnostic accuracy of 64-row multidetector cardiac computed tomography (MDCT) in detecting aortic regurgitation (AR) on prospectively acquired images with trans-thoracic echocardiography (TTE) as a reference standard.

Materials and Methods

Forty-three consecutive patients underwent MDCT and TTE. AR was defined on MDCT images acquired at 75% phase of R-R interval as the lack of aortic cusps coaptation. The maximum regurgitant orifice area (ROA) was planimetered and compared to TTE.

Results

All 29 patients with AR on TTE were correctly identified by MDCT. The sensitivity, specificity, positive predictive value, and negative predictive value of MDCT were 100%, 85.7%, 93.5%, and 100%, respectively. Sixteen, nine, and four patients were found to have mild, moderate, and severe AR on TTE, respectively. The corresponding ROA by MDCT were 3.25 ± 1.04 mm², 4.16 ± 1.19 mm², and 11.30 ± 6.13 mm², respectively.

Conclusion

MDCT data acquired for the coronary artery evaluation can be used for the detection of aortic regurgitation with high diagnostic accuracy without additional scanning or radiation and can support appropriate referral for TTE.

Key Words: Aortic regurgitation, cardiac computed tomography, trans-thoracic echocardiography