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

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 mGy.cm for the non-contrast-enhanced (n=40), arterial (n=43) and delayed acquisition (n=43), respectively. The mean total DLP was 569 +/- 208 mGy.cm 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.