Three-dimensional cardiac computed tomography compared with autopsied material for the assessment of the mitral valve

Area of Science:

• Cardiovascular Imaging
• Anatomical Pathology
• Medical Technology

Background:

• Accurate assessment of mitral valve morphology is crucial for diagnosing and managing cardiovascular diseases.
• Three-dimensional (3D) cardiac computed tomography (CT) offers a non-invasive method for visualizing cardiac structures.
• Macroscopic analysis of autopsied hearts provides detailed anatomical measurements.

Purpose of the Study:

• To compare the morphometrical features of non-diseased mitral valves using 3D cardiac CT versus macroscopic autopsy analysis.
• To evaluate the accuracy of 3D cardiac CT in measuring mitral valve dimensions.
• To identify discrepancies between in vivo imaging and ex vivo measurements.

Main Methods:

• Analysis of 51 3D cardiac CT scans and 120 autopsied healthy human hearts.
• Utilized Mimics Innovation Suite software for 3D reconstruction, segmentation, and measurement of the mitral valve complex.
• Performed direct comparison of key mitral valve parameters between CT imaging and macroscopic analysis.

Main Results:

• Significant overestimation of intercommisural diameter, aorto-mural diameter, and mitral annulus perimeter in 3D cardiac CT compared to autopsy (p < 0.0001).
• The ratio of intercommissural/aorto-mural diameter showed comparable values between the two groups.
• Anterior mitral leaflet size was larger in autopsied specimens, while P2 scallop height showed no significant difference.

Conclusions:

• 3D cardiac CT provides accurate visualization of mitral valve structure, valuable for non-invasive assessment.
• Contrast-enhanced 3D cardiac CT significantly overestimates mitral annulus measurements compared to postmortem analysis.
• Understanding these discrepancies is vital for accurate interpretation of cardiac CT findings in mitral valve assessment.