Advanced CT acquisition protocol with a third-generation dual-source CT scanner and iterative reconstruction technique for comprehensive prosthetic heart valve assessment

Marguerite E. Faure, Laurens E. Swart, Marcel L. Dijkshoorn, Jos A. Bekkers, Marcel van Straten, Koen Nieman, Paul M. Parizel, Gabriel P. Krestin, Ricardo P. J. Budde

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Multidetector CT (MDCT) is a valuable tool for functional prosthetic heart valve (PHV) assessment. However, radiation exposure remains a concern. We assessed a novel CT-acquisition protocol for comprehensive PHV evaluation at limited dose.

Patients with a PHV were scanned using a third-generation dual-source CT scanner (DSCT) and iterative reconstruction technique (IR). Three acquisitions were obtained: a non-enhanced scan; a contrast-enhanced, ECG-triggered, arterial CT angiography (CTA) scan with reconstructions at each 5 % of the R-R interval; and a delayed high-pitch CTA of the entire chest. Image quality was scored on a five-point scale. Radiation dose was obtained from the reported CT dose index (CTDI) and dose length product (DLP).

We analysed 43 CT examinations. Mean image quality score was 4.1 +/- 1.4, 4.7 +/- 0.5 and 4.2 +/- 0.6 for the non-contrast-enhanced, arterial and delayed acquisitions, respectively, with a total mean image quality of 4.3 +/- 0.7. Mean image quality for leaflet motion was 3.9 +/- 1.4. Mean DLP was 28.2 +/- 17.1, 457.3 +/- 168.6 and 68.5 +/- 47.2 for the non-contrast-enhanced (n=40), arterial (n=43) and delayed acquisition (n=43), respectively. The mean total DLP was 569 +/- 208 and mean total radiation dose was 8.3 +/- 3.0 mSv (n=43).

Comprehensive assessment of PHVs is possible using DSCT and IR at moderate radiation dose.

aEuro cent Prosthetic heart valve dysfunction is a potentially life-threatening condition.

aEuro cent Dual-source CT can adequately assess valve leaflet motion and anatomy.

aEuro cent We assessed a comprehensive protocol with three acquisitions for PHV evaluation.

aEuro cent This protocol is associated with good image quality and limited dose.

Original languageEnglish
Pages (from-to)2159-2168
Number of pages10
JournalEuropean Radiology
Issue number5
Publication statusPublished - May 2018
Externally publishedYes

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