Scrollable Display of Radial Sectional Computed Tomography Images for Complex Mitral Valve Anatomy

Advances in computed tomography (CT) technology have increased its utility in the diagnosis of mitral regurgitation (MR). Herein, we report on a unique dual-panel display for high-resolution valve images of radial multiplanar reconstruction named mitral valve-radial sectional view (MV-RSV) and a case of mitral valve repair for MR that demonstrates the usefulness of this display method.

Whole-heart images from contrast-enhanced CT were acquired with electrocardiographic gating and processed to reconstruct 3-dimensional and cross-sectional images. The new display consisted of the selection panel and cross section panel, the latter showing the desired radial section selected by scrolling to present the morphologic features of the mitral valve leaflets and subvalvular structures. The patient was a 63-year-old man with MR who underwent valve repair. In addition to echocardiography, the mitral valve was evaluated preoperatively and postoperatively by CT using MV-RSV.

Preoperative MV-RSV revealed P2 prolapse where severe MR with chordal rupture was assessed by transesophageal echocardiography. After the mitral valve repair with chordal plasty and ring annuloplasty, MV-RSV clarified the gap between leaflets at the P2-P3 indentation, which was associated with mild residual leakage.

The new scrollable CT display is a simple and convenient method to show the structure of lesions that cause MR and is useful for developing treatment strategies and postoperative evaluation.