Utility of Cardiac CT vs. MRI in Mitral Valve Architecture Evaluation

INTRODUCTION: New minimally invasive and percutaneous techniques are being developed to repair and replace the mitral valve. These procedures rely upon the knowledge of the exact structure of the mitral valve and its surrounding structures. However, there has not been a standard method identified to accurately assess the mitral apparatus. METHODS: Perform an anatomic study to evaluate various structures associated with the mitral valve and mitral valve apparatus in 40 cadaveric hearts. The anatomic study will serve as baseline for comparison with a subsequent pilot imaging study, consisting of retrospective in vivo assessment of mitral valve and associated structures with cardiac computed tomography (CT) and magnetic resonance imaging (MRI) in four subjects. Main anatomic structures were qualitatively assessed on both imaging methods using a 5-point Likert scale. Imaging measurements were compared with anatomic study measurements. RESULTS: After analyzing the cardiac CT and cardiac MRI images, we found the cardiac CT was the only modality reliable to obtain measurements of the mitral valve apparatus. The cardiac MRI was unreliable in assessing the mitral valve apparatus and is supported by the quality assessment, which demonstrates that cardiac CT images are better to read for the mitral valve structures that were analyzed. CONCLUSION: Cardiac CT is the superior method in identifying the mitral valve apparatus in comparison to cardiac MRIs. The use of cardiac CTs may benefit physicians to formulate pre-op treatment plans but needs further research and development.