Cardiac Computed Tomography versus Echocardiography in the Assessment of Stenotic Rheumatic Mitral Valve

Purpose There are different clinical cardiac applications of dual source computed tomography ( DSCT ). Here, we aimed to compare the DSCT with the transthoracic echocardiography ( TTE ) for evaluating the Wilkins score and planimetric mitral valve area ( MVA ) of a rheumatic stenotic mitral valve. Materials and Methods We prospectively evaluated mitral valvular structure and function in 31 patients with known mitral stenosis undergoing electrocardiogram‐gated, second‐generation DSCT , in our heart center for different indications. Mitral valve was evaluated using Wilkins score, and also, the planimetric MVA was assessed. Results We found a significant difference between MVA s determined by DSCT (average 1.42 ± 0.44 cm 2 ) and MVA s determined by TTE (average 1.35 ± 0.43 cm 2 ; difference 0.07 ± 0.16 cm 2 ; P = 0.018). Linear regression analysis revealed a good correlation between the two techniques (r = 0.934; P < 0.0001). The limits of agreement for DSCT and TTE in the Bland–Altman analysis were ±0.31 cm 2 . DSCT using TTE as the reference enabled good discrimination between mild and moderate‐to‐severe stenosis and had an area under the ROC curve of 0.967 ( CI 0.912–1.023; P < 0.0001). Wilkins scores obtained by DSCT (7.51 ± 1.17, range 5–10) and TTE (8.16 ± 1.27, range 6–10) had a moderate correlation (r = 0.686; P < 0.0001). Conclusion We found that planimetric MVA measurements assessed by DSCT were closely correlated with MVA calculations by TTE . The moderate correlation was observed for the Wilkins score.