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Case history: Exclusion of coronary artery disease prior to flecainid therapy. Diagnosis: Coronary artery disease can be excluded. Read more

Case history 81-year-old male presented for follow-up exam to indicate convalescence progress. 6 weeks before, he had been delivered for coiling and stent implantation due to ruptured aneurysm. He had complained about pain in the lower abdominal region. A day after the stent implantation a type II endoleakage had appeared. 4 … Read more

Case history: Stroke; Diagnosis: The cranial arteries and veins are patent. Read more

Case History: Acute chest pain – Triple rule out; Diagnosis: Subsegmental pulmonary embolism. Read more

Case history: DECT images of patients with known gout. Images of the right knee reveals uric acid (UA) deposits along the collateral & cruciate ligaments and in the prepatellar region. It is evident that with the material decomposition algorithm, UA can be clearly depicted in red thereby confirming the diagnosis … Read more

Case history: 64 year-old female presents with history of neck and chest pain. Diagnosis: Thickened quadricuspid pulmonary valve. Aneurysmal dilatation and asymmetry of pulmonary arteries. Stenosis of mid LAD with a component of myocardial bridging. Read more

Case history: Child with nepphroblastoma before initiation of chemotherapy. Diagnosis: Exclusion of infiltrates Read more

History
49-year old male referred to CT for evaluation of aortic valve. Besides asthma and history of colonoscopy, the patient was in good health. Physical examination revealed a heart murmur. The baseline echocardiogram reported normal tricuspid aortic root with moderate aortic regurgitation (AI) and EF of 60 %.

Question
Detection of morphology of aortic root, and severity of aortic regurgitation for surgical planning.

Diagnosis/Differential diagnosis
Aortic valve disorder – moderately severe AI

Findings
The 3D and 4D assessment of aortic root demonstrates a bicuspid aortic valve with partial fusion between non- and right coronary cusps. There is a mild prolapse of the partially fused non- and right cusp with incomplete diastolic coaptation. The area of the diastolic opening measures 0.23 cm². The diastolic opening formed by thick raphe is likely associated with severe aortic insufficiency. The absence of aortic valve calcification is noted.

Comments
Cardiac MDCT proves to be reliable source for detection of morphology of aortic valve. 4D images of phases between 0-90 % enable functional assessment of aortic valve and identification of degree of severity of valvular disorders.

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Movie 1: Cross sectional image of aortic valve showing partial fusion of non- and right coronary cusps, and central diastolic opening.


Figure 2: Cross sectional image showing the measurement of diastolic opening area in planimetry.

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Movie 3: Image showing mild prolapse of aortic valve cusps and diastolic coaptation.

Authors: Sandra Halliburton and Paul Schoenhagen

Two interesting questions about CT in pediatrics have been asked on DSCT.com some time ago. As Dr. Hyun Woo Goo, who is an expert in pediatrics, recently joined the DSCT expert community, DSCT.com asked him to comment on these questions as well. Read his answers here. The following questions … Read more

The following question has been sent by Patrick, CT Tech: Our facilty is currently operating a siemens Definition Scanner. I was hoping you could recommend some reading material on Dual Source CT. Also some info on how to reduce radiation exposure. Ralf Bauer, MD, Clinic of the Goethe University, Frankfurt, Germany: Dear … Read more