Abstract 2754: Aortic Valve Area on 64-Slice Computed Tomography Strongly Correlates with Transesophageal Echocardiography in Aortic Stenosis
Objective: The purpose of this study was to assess the ability of multidetector computed tomography (MDCT) to determine aortic valve area (AVA) in patients with aortic stenosis.
Methods: Transesophageal echocardiography (TEE) and 64-slice ECG-gated MDCT of 78 consecutive patients with aortic stenosis were retrospectively, independently, and blindly reviewed by 1 cardiologist and 2 radiologists. The accuracy of MDCT for detection of severe aortic stenosis (AVA < 1 cm2) was compared to AVA determined by planimetry from TEE and by the continuity equation (CE) from transthoracic echocardiography. Pearson correlations were performed between groups.
Results: The median AVA on TEE was 0.7 ± 0.9 cm2. AVA could be assessed with TEE in 63 patients, with CE in 47 patients, and with MDCT in all 78 patients. There was strong correlation between AVA by MDCT and TEE (n = 63; mean difference < -0.1 ± 0.5 cm2; r = 0.84, p < 0.001) and by MDCT and CE (n = 47; mean difference = 0.1 ± 0.3 cm2; r= 0.81, p < 0.001). The sensitivity and specificity to detect severe aortic stenosis by MDCT were 93% and 90%, respectively, when compared to TEE, and 83% and 90% by CE. AVA on MDCT had excellent interobserver correlation (n = 78; mean difference < 0.1 ± 0.3 cm2; r = 0.91, p < 0.001).
Conclusion: AVA on MDCT strongly correlates with AVA by TEE and the CE and has excellent sensitivity and specificity for the detection of severe aortic stenosis. AVA should be reported on gated MDCT of the heart and thoracic aorta.