Abstract 17408: Anatomical Characterization of Mitral Valve Prolapse with Cardiac CT is Less Accurate than Echocardiography: Comparison with Surgical Findings
Introduction: Cardiac CT is rapidly gaining acceptance for the detection of coronary artery disease. There is limited data supporting its use for the assessment of valve anatomy. A single imaging modality that can assess both coronary and mitral valve anatomy prior to surgery may be desirable.
Hypothesis: Cardiac CT has similar diagnostic accuracy for identifying and characterizing mitral valve prolapse (MVP) compared to echocardiography (echo).
Methods: Consecutive patients referred to cardiac CT prior to cardiac surgery were included in the study. CT Results of MVP were compared to echo and surgical pathology. MVP on echo and cardiac CT was defined as systolic prolapse of the mitral valve leaflet ≥ 2 mm beyond the mitral annulus in the 3 chamber view. The involvement of individual leaflets (anterior and/or posterior mitral valve leaflets) and scallops (A1, A2, A3, P1, P2, and/or P3) were also identified.
Results: Between Feb 2006 and Feb 2010, 67 consecutive patients were prospectively enrolled. Intraoperative MV findings were available for 32 patients, echo for 65 patients, and cardiac CT results for 65 patients. Using intraoperative findings as the gold standard, cardiac CT detected any MVP with similar sensitivity (84.6 %; 95% CI 62.9–92.1%) and specificity (100%; 95% CI 51.7%–100%) as echo (sensitivity = 92.3; 95% CI 73.4–98.6%) and specificity =100%, 95% CI 51.7–100%)). For the identification of individual scallops, CT had lower sensitivity (58.1%; 95% CI 44.8–70.3%) and specificity (89.9 % 95% CI 83.6–94.0%) compared with the sensitivity (78.1 %; 95% CI 65.7–87.1%) and specificity (97.3%; 95% CI 92.8–99.1%) of echo.
Conclusion: Although cardiac CT and echo had similar diagnostic accuracy for detecting any MVP compared to surgical findings, echo appeared to have better sensitivity and specificity for the detection of individual scallop prolapse. Though CT appears to be able to identify patients with MVP, echo should be used to characterize individual scallops.
- © 2010 by American Heart Association, Inc.