Identification of prolapsing mitral valve scallops by a three-dimensional multiplanar reconstruction method

Area of Science:

• Cardiology
• Medical Imaging
• Echocardiography

Background:

• Mitral valve prolapse (MVP) diagnosis relies on accurate imaging.
• Distinguishing prolapsing mitral valve (MV) scallops is crucial for surgical planning.

Purpose of the Study:

• To evaluate the diagnostic accuracy of 3D multiplanar reconstruction (MPR) for prolapsing MV scallops.
• To compare 2D transthoracic echocardiography (TTE) and 3D MPR against 2D transesophageal echocardiography (TEE) in MVP patients.

Main Methods:

• Retrospective analysis of 55 MVP patients undergoing MV repair/replacement.
• Echocardiographic assessment using 2D TEE, 2D TTE, and 3D MPR.
• Operative findings served as the gold standard for comparison.

Main Results:

• 3D MPR combined with 2D TTE showed strong agreement with operative findings for anterior and posterior leaflets and P2 scallop.
• Moderate to strong agreement was observed for A2 and A3 scallops when using 3D MPR with 2D TTE.
• 2D TEE also demonstrated strong agreement for posterior leaflet and P2 scallop, and moderate agreement for anterior leaflet and A2 scallop.

Conclusions:

• Three-dimensional MPR is a valuable addition to echocardiographic techniques for MVP evaluation.
• Combining 3D MPR with 2D TTE enhances preoperative assessment of MVP patients.