Identifying fragile calcifications of the aortic valve in transcatheter aortic valve replacement: iodine concentration of aortic valvular calcification by spectral CT
Objective To demonstrate the relationship between spectral computed tomography (CT) measured iodine concentration and strength of aortic valvular calcification (AVC) in patients with aortic valve stenosis (AVS). Methods A retrospective study was performed on patients who underwent transcatheter aort...
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| Veröffentlicht in: | European radiology 2023-03, Vol.33 (3), p.1963-1972 |
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| container_title | European radiology |
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| creator | Park, Soojung Cho, Yongwon Oh, Yu-Whan Ko, Minseok Lim, Do-Sun Yu, Cheol Woong Park, Seong-Mi Kim, Mi-Na Hwang, Sung Ho |
| description | Objective
To demonstrate the relationship between spectral computed tomography (CT) measured iodine concentration and strength of aortic valvular calcification (AVC) in patients with aortic valve stenosis (AVS).
Methods
A retrospective study was performed on patients who underwent transcatheter aortic valve replacement (TAVR) for symptomatic AVS and underwent both pre and postprocedural electrocardiogram gated CT scans using a spectral CT system. Preprocedural CT was used to evaluate the volume and iodine concentration (IC) in the AVC. Postprocedural CT data were used to calculate the volume reduction percentage (VRP) of AVC. Multiple linear regression analysis was used to identify the independent variables related to the VRP in AVCs.
Results
A total of 94 AVCs were selected from 22 patients. The mean volume and IC of the AVCs before TAVR were 0.37 mL ± 0.15 mL and 7 mg/mL ± 10.5 mg/mL, respectively. After TAVR, a median VRP of all 94 AVCs was 18.5%. Multiple linear regression analysis showed that the IC was independently associated with the VRP (coefficient = 1.64,
p
< 0.001). When an optimal IC cutoff point was set at 4 mg/mL in the assessment of a fragile AVC which showed the VRP was > 18.5%, the sensitivity was 63%; specificity, 91%; positive predictive value, 88%; and negative predictive value, 71%.
Conclusions
When using spectral CT to prepare the TAVR, measuring the IC of the AVC may be useful to assess the probability of AVC deformity after TAVR.
Key Points
•
A dual-layer detector-based spectral CT enables quantifying iodine of contrast media in the aortic valve calcification (AVC) on contrast-enhanced CT images.
•
The AVC including iodine of contrast media on contrast-enhanced CT image may have loose compositions, associated with the deformity of AVC after TAVR.
•
Measuring the iodine concentration in AVC may have the potential to assess the probability of AVC deformity, which may be associated with the outcome and complications after TAVR.
2 |
| doi_str_mv | 10.1007/s00330-022-09133-3 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2715442577</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2715442577</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-96f47c92cde162fe84bd2d701618cc632beb3579618efb95086102cb755441533</originalsourceid><addsrcrecordid>eNp9kclOwzAQhi0EYn8BDsgSFy4BL0nccEMVSyUkLuVsOc64GLl2sROkvhDPiUvZD5zs0XzzzUg_QkeUnFFCxHkihHNSEMYK0lDOC76BdmnJWUHJqNz88d9Beyk9EZKxUmyjHV5TymhDd9HrpAPfW7O0foZNVDPrAGvltDVWq94Gn3AwuH8ErELsrcYvyr0Ath73UfmUmUfoIf7uRlg4pWGe1RfYhs76LA1e5zq-S1fOHxODU_H3VtwucVqAzrzD4-kB2jLKJTj8ePfRw_XVdHxb3N3fTMaXd4XmouqLpjal0A3THdCaGRiVbcc6QWhNR1rXnLXQ8ko0uQTTNhUZ1ZQw3YqqKktacb6PTtfeRQzPA6Rezm3S4JzyEIYkmaCZZJUQGT35gz6FIfp8XaaEyPvrqskUW1M6hpQiGLmIdq7iUlIiVynKdYoypyjfU5SrK44_1EM7h-5r5DO2DPA1kHLLzyB-7_5H-wbfNqpY</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2777162659</pqid></control><display><type>article</type><title>Identifying fragile calcifications of the aortic valve in transcatheter aortic valve replacement: iodine concentration of aortic valvular calcification by spectral CT</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Park, Soojung ; Cho, Yongwon ; Oh, Yu-Whan ; Ko, Minseok ; Lim, Do-Sun ; Yu, Cheol Woong ; Park, Seong-Mi ; Kim, Mi-Na ; Hwang, Sung Ho</creator><creatorcontrib>Park, Soojung ; Cho, Yongwon ; Oh, Yu-Whan ; Ko, Minseok ; Lim, Do-Sun ; Yu, Cheol Woong ; Park, Seong-Mi ; Kim, Mi-Na ; Hwang, Sung Ho</creatorcontrib><description>Objective
To demonstrate the relationship between spectral computed tomography (CT) measured iodine concentration and strength of aortic valvular calcification (AVC) in patients with aortic valve stenosis (AVS).
Methods
A retrospective study was performed on patients who underwent transcatheter aortic valve replacement (TAVR) for symptomatic AVS and underwent both pre and postprocedural electrocardiogram gated CT scans using a spectral CT system. Preprocedural CT was used to evaluate the volume and iodine concentration (IC) in the AVC. Postprocedural CT data were used to calculate the volume reduction percentage (VRP) of AVC. Multiple linear regression analysis was used to identify the independent variables related to the VRP in AVCs.
Results
A total of 94 AVCs were selected from 22 patients. The mean volume and IC of the AVCs before TAVR were 0.37 mL ± 0.15 mL and 7 mg/mL ± 10.5 mg/mL, respectively. After TAVR, a median VRP of all 94 AVCs was 18.5%. Multiple linear regression analysis showed that the IC was independently associated with the VRP (coefficient = 1.64,
p
< 0.001). When an optimal IC cutoff point was set at 4 mg/mL in the assessment of a fragile AVC which showed the VRP was > 18.5%, the sensitivity was 63%; specificity, 91%; positive predictive value, 88%; and negative predictive value, 71%.
Conclusions
When using spectral CT to prepare the TAVR, measuring the IC of the AVC may be useful to assess the probability of AVC deformity after TAVR.
Key Points
•
A dual-layer detector-based spectral CT enables quantifying iodine of contrast media in the aortic valve calcification (AVC) on contrast-enhanced CT images.
•
The AVC including iodine of contrast media on contrast-enhanced CT image may have loose compositions, associated with the deformity of AVC after TAVR.
•
Measuring the iodine concentration in AVC may have the potential to assess the probability of AVC deformity, which may be associated with the outcome and complications after TAVR.
2</description><identifier>ISSN: 1432-1084</identifier><identifier>ISSN: 0938-7994</identifier><identifier>EISSN: 1432-1084</identifier><identifier>DOI: 10.1007/s00330-022-09133-3</identifier><identifier>PMID: 36112191</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Aorta ; Aortic valve ; Aortic Valve - diagnostic imaging ; Aortic Valve - surgery ; Aortic Valve Stenosis - complications ; Aortic Valve Stenosis - diagnostic imaging ; Aortic Valve Stenosis - surgery ; Calcification ; Calcification (ectopic) ; Cardiac ; Complications ; Computed tomography ; Contrast agents ; Contrast media ; Contrast Media - pharmacology ; Diagnostic Radiology ; EKG ; Electrocardiography ; Heart valves ; Humans ; Image contrast ; Image enhancement ; Imaging ; Independent variables ; Internal Medicine ; Interventional Radiology ; Iodine ; Medical imaging ; Medicine ; Medicine & Public Health ; Neuroradiology ; Radiology ; Regression analysis ; Retrospective Studies ; Risk Factors ; Severity of Illness Index ; Statistical analysis ; Stenosis ; Tomography, X-Ray Computed - methods ; Transcatheter Aortic Valve Replacement ; Ultrasound</subject><ispartof>European radiology, 2023-03, Vol.33 (3), p.1963-1972</ispartof><rights>The Author(s), under exclusive licence to European Society of Radiology 2022. Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2022. The Author(s), under exclusive licence to European Society of Radiology.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-96f47c92cde162fe84bd2d701618cc632beb3579618efb95086102cb755441533</citedby><cites>FETCH-LOGICAL-c375t-96f47c92cde162fe84bd2d701618cc632beb3579618efb95086102cb755441533</cites><orcidid>0000-0003-1850-0751</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00330-022-09133-3$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00330-022-09133-3$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36112191$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Park, Soojung</creatorcontrib><creatorcontrib>Cho, Yongwon</creatorcontrib><creatorcontrib>Oh, Yu-Whan</creatorcontrib><creatorcontrib>Ko, Minseok</creatorcontrib><creatorcontrib>Lim, Do-Sun</creatorcontrib><creatorcontrib>Yu, Cheol Woong</creatorcontrib><creatorcontrib>Park, Seong-Mi</creatorcontrib><creatorcontrib>Kim, Mi-Na</creatorcontrib><creatorcontrib>Hwang, Sung Ho</creatorcontrib><title>Identifying fragile calcifications of the aortic valve in transcatheter aortic valve replacement: iodine concentration of aortic valvular calcification by spectral CT</title><title>European radiology</title><addtitle>Eur Radiol</addtitle><addtitle>Eur Radiol</addtitle><description>Objective
To demonstrate the relationship between spectral computed tomography (CT) measured iodine concentration and strength of aortic valvular calcification (AVC) in patients with aortic valve stenosis (AVS).
Methods
A retrospective study was performed on patients who underwent transcatheter aortic valve replacement (TAVR) for symptomatic AVS and underwent both pre and postprocedural electrocardiogram gated CT scans using a spectral CT system. Preprocedural CT was used to evaluate the volume and iodine concentration (IC) in the AVC. Postprocedural CT data were used to calculate the volume reduction percentage (VRP) of AVC. Multiple linear regression analysis was used to identify the independent variables related to the VRP in AVCs.
Results
A total of 94 AVCs were selected from 22 patients. The mean volume and IC of the AVCs before TAVR were 0.37 mL ± 0.15 mL and 7 mg/mL ± 10.5 mg/mL, respectively. After TAVR, a median VRP of all 94 AVCs was 18.5%. Multiple linear regression analysis showed that the IC was independently associated with the VRP (coefficient = 1.64,
p
< 0.001). When an optimal IC cutoff point was set at 4 mg/mL in the assessment of a fragile AVC which showed the VRP was > 18.5%, the sensitivity was 63%; specificity, 91%; positive predictive value, 88%; and negative predictive value, 71%.
Conclusions
When using spectral CT to prepare the TAVR, measuring the IC of the AVC may be useful to assess the probability of AVC deformity after TAVR.
Key Points
•
A dual-layer detector-based spectral CT enables quantifying iodine of contrast media in the aortic valve calcification (AVC) on contrast-enhanced CT images.
•
The AVC including iodine of contrast media on contrast-enhanced CT image may have loose compositions, associated with the deformity of AVC after TAVR.
•
Measuring the iodine concentration in AVC may have the potential to assess the probability of AVC deformity, which may be associated with the outcome and complications after TAVR.
2</description><subject>Aorta</subject><subject>Aortic valve</subject><subject>Aortic Valve - diagnostic imaging</subject><subject>Aortic Valve - surgery</subject><subject>Aortic Valve Stenosis - complications</subject><subject>Aortic Valve Stenosis - diagnostic imaging</subject><subject>Aortic Valve Stenosis - surgery</subject><subject>Calcification</subject><subject>Calcification (ectopic)</subject><subject>Cardiac</subject><subject>Complications</subject><subject>Computed tomography</subject><subject>Contrast agents</subject><subject>Contrast media</subject><subject>Contrast Media - pharmacology</subject><subject>Diagnostic Radiology</subject><subject>EKG</subject><subject>Electrocardiography</subject><subject>Heart valves</subject><subject>Humans</subject><subject>Image contrast</subject><subject>Image enhancement</subject><subject>Imaging</subject><subject>Independent variables</subject><subject>Internal Medicine</subject><subject>Interventional Radiology</subject><subject>Iodine</subject><subject>Medical imaging</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neuroradiology</subject><subject>Radiology</subject><subject>Regression analysis</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Severity of Illness Index</subject><subject>Statistical analysis</subject><subject>Stenosis</subject><subject>Tomography, X-Ray Computed - methods</subject><subject>Transcatheter Aortic Valve Replacement</subject><subject>Ultrasound</subject><issn>1432-1084</issn><issn>0938-7994</issn><issn>1432-1084</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9kclOwzAQhi0EYn8BDsgSFy4BL0nccEMVSyUkLuVsOc64GLl2sROkvhDPiUvZD5zs0XzzzUg_QkeUnFFCxHkihHNSEMYK0lDOC76BdmnJWUHJqNz88d9Beyk9EZKxUmyjHV5TymhDd9HrpAPfW7O0foZNVDPrAGvltDVWq94Gn3AwuH8ErELsrcYvyr0Ath73UfmUmUfoIf7uRlg4pWGe1RfYhs76LA1e5zq-S1fOHxODU_H3VtwucVqAzrzD4-kB2jLKJTj8ePfRw_XVdHxb3N3fTMaXd4XmouqLpjal0A3THdCaGRiVbcc6QWhNR1rXnLXQ8ko0uQTTNhUZ1ZQw3YqqKktacb6PTtfeRQzPA6Rezm3S4JzyEIYkmaCZZJUQGT35gz6FIfp8XaaEyPvrqskUW1M6hpQiGLmIdq7iUlIiVynKdYoypyjfU5SrK44_1EM7h-5r5DO2DPA1kHLLzyB-7_5H-wbfNqpY</recordid><startdate>20230301</startdate><enddate>20230301</enddate><creator>Park, Soojung</creator><creator>Cho, Yongwon</creator><creator>Oh, Yu-Whan</creator><creator>Ko, Minseok</creator><creator>Lim, Do-Sun</creator><creator>Yu, Cheol Woong</creator><creator>Park, Seong-Mi</creator><creator>Kim, Mi-Na</creator><creator>Hwang, Sung Ho</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1850-0751</orcidid></search><sort><creationdate>20230301</creationdate><title>Identifying fragile calcifications of the aortic valve in transcatheter aortic valve replacement: iodine concentration of aortic valvular calcification by spectral CT</title><author>Park, Soojung ; Cho, Yongwon ; Oh, Yu-Whan ; Ko, Minseok ; Lim, Do-Sun ; Yu, Cheol Woong ; Park, Seong-Mi ; Kim, Mi-Na ; Hwang, Sung Ho</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-96f47c92cde162fe84bd2d701618cc632beb3579618efb95086102cb755441533</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Aorta</topic><topic>Aortic valve</topic><topic>Aortic Valve - diagnostic imaging</topic><topic>Aortic Valve - surgery</topic><topic>Aortic Valve Stenosis - complications</topic><topic>Aortic Valve Stenosis - diagnostic imaging</topic><topic>Aortic Valve Stenosis - surgery</topic><topic>Calcification</topic><topic>Calcification (ectopic)</topic><topic>Cardiac</topic><topic>Complications</topic><topic>Computed tomography</topic><topic>Contrast agents</topic><topic>Contrast media</topic><topic>Contrast Media - pharmacology</topic><topic>Diagnostic Radiology</topic><topic>EKG</topic><topic>Electrocardiography</topic><topic>Heart valves</topic><topic>Humans</topic><topic>Image contrast</topic><topic>Image enhancement</topic><topic>Imaging</topic><topic>Independent variables</topic><topic>Internal Medicine</topic><topic>Interventional Radiology</topic><topic>Iodine</topic><topic>Medical imaging</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neuroradiology</topic><topic>Radiology</topic><topic>Regression analysis</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Severity of Illness Index</topic><topic>Statistical analysis</topic><topic>Stenosis</topic><topic>Tomography, X-Ray Computed - methods</topic><topic>Transcatheter Aortic Valve Replacement</topic><topic>Ultrasound</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Park, Soojung</creatorcontrib><creatorcontrib>Cho, Yongwon</creatorcontrib><creatorcontrib>Oh, Yu-Whan</creatorcontrib><creatorcontrib>Ko, Minseok</creatorcontrib><creatorcontrib>Lim, Do-Sun</creatorcontrib><creatorcontrib>Yu, Cheol Woong</creatorcontrib><creatorcontrib>Park, Seong-Mi</creatorcontrib><creatorcontrib>Kim, Mi-Na</creatorcontrib><creatorcontrib>Hwang, Sung Ho</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>European radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Park, Soojung</au><au>Cho, Yongwon</au><au>Oh, Yu-Whan</au><au>Ko, Minseok</au><au>Lim, Do-Sun</au><au>Yu, Cheol Woong</au><au>Park, Seong-Mi</au><au>Kim, Mi-Na</au><au>Hwang, Sung Ho</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Identifying fragile calcifications of the aortic valve in transcatheter aortic valve replacement: iodine concentration of aortic valvular calcification by spectral CT</atitle><jtitle>European radiology</jtitle><stitle>Eur Radiol</stitle><addtitle>Eur Radiol</addtitle><date>2023-03-01</date><risdate>2023</risdate><volume>33</volume><issue>3</issue><spage>1963</spage><epage>1972</epage><pages>1963-1972</pages><issn>1432-1084</issn><issn>0938-7994</issn><eissn>1432-1084</eissn><abstract>Objective
To demonstrate the relationship between spectral computed tomography (CT) measured iodine concentration and strength of aortic valvular calcification (AVC) in patients with aortic valve stenosis (AVS).
Methods
A retrospective study was performed on patients who underwent transcatheter aortic valve replacement (TAVR) for symptomatic AVS and underwent both pre and postprocedural electrocardiogram gated CT scans using a spectral CT system. Preprocedural CT was used to evaluate the volume and iodine concentration (IC) in the AVC. Postprocedural CT data were used to calculate the volume reduction percentage (VRP) of AVC. Multiple linear regression analysis was used to identify the independent variables related to the VRP in AVCs.
Results
A total of 94 AVCs were selected from 22 patients. The mean volume and IC of the AVCs before TAVR were 0.37 mL ± 0.15 mL and 7 mg/mL ± 10.5 mg/mL, respectively. After TAVR, a median VRP of all 94 AVCs was 18.5%. Multiple linear regression analysis showed that the IC was independently associated with the VRP (coefficient = 1.64,
p
< 0.001). When an optimal IC cutoff point was set at 4 mg/mL in the assessment of a fragile AVC which showed the VRP was > 18.5%, the sensitivity was 63%; specificity, 91%; positive predictive value, 88%; and negative predictive value, 71%.
Conclusions
When using spectral CT to prepare the TAVR, measuring the IC of the AVC may be useful to assess the probability of AVC deformity after TAVR.
Key Points
•
A dual-layer detector-based spectral CT enables quantifying iodine of contrast media in the aortic valve calcification (AVC) on contrast-enhanced CT images.
•
The AVC including iodine of contrast media on contrast-enhanced CT image may have loose compositions, associated with the deformity of AVC after TAVR.
•
Measuring the iodine concentration in AVC may have the potential to assess the probability of AVC deformity, which may be associated with the outcome and complications after TAVR.
2</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>36112191</pmid><doi>10.1007/s00330-022-09133-3</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0003-1850-0751</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1432-1084 |
| ispartof | European radiology, 2023-03, Vol.33 (3), p.1963-1972 |
| issn | 1432-1084 0938-7994 1432-1084 |
| language | eng |
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| source | MEDLINE; SpringerNature Journals |
| subjects | Aorta Aortic valve Aortic Valve - diagnostic imaging Aortic Valve - surgery Aortic Valve Stenosis - complications Aortic Valve Stenosis - diagnostic imaging Aortic Valve Stenosis - surgery Calcification Calcification (ectopic) Cardiac Complications Computed tomography Contrast agents Contrast media Contrast Media - pharmacology Diagnostic Radiology EKG Electrocardiography Heart valves Humans Image contrast Image enhancement Imaging Independent variables Internal Medicine Interventional Radiology Iodine Medical imaging Medicine Medicine & Public Health Neuroradiology Radiology Regression analysis Retrospective Studies Risk Factors Severity of Illness Index Statistical analysis Stenosis Tomography, X-Ray Computed - methods Transcatheter Aortic Valve Replacement Ultrasound |
| title | Identifying fragile calcifications of the aortic valve in transcatheter aortic valve replacement: iodine concentration of aortic valvular calcification by spectral CT |
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