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Erschienen in: Pediatric Radiology 5/2007

01.05.2007 | Original Article

Evaluation of aortic regurgitation in congenital heart disease: value of MR imaging in comparison to echocardiography

verfasst von: Sebastian Ley, Joachim Eichhorn, Julia Ley-Zaporozhan, Herbert Ulmer, Jens-Peter Schenk, Hans-Ulrich Kauczor, Raoul Arnold

Erschienen in: Pediatric Radiology | Ausgabe 5/2007

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Abstract

Background

Evaluation of the severity and the follow-up of aortic insufficiency (AI) are important tasks in paediatric cardiology. Assessment is based on clinical and echocardiographic (ECHO) findings such as the configuration of the valve and the regurgitation fraction (RF).

Objective

The goal of this study was to evaluate MRI compared to ECHO for determination of clinical severity, valve morphology and RF.

Materials and methods

Thirty patients (age 3–27 years) with mild-to-severe AI were evaluated by clinical examination, ECHO (2-D and Doppler), and MRI at 1.5 T (2-D true-FISP cine short axis, phase-contrast flow in the ascending aorta).

Results

Both methods identified 13 bicuspid and 17 tricuspid valves. Good correlations between ECHO and cine MRI were found for ventricular mass, stroke volume, and ejection fraction. A good linear correlation was found for the RF determined by ECHO and phase-contrast MRI (r = 0.7). The RF was 6% in mild AI, 17% in moderate AI, and 30% in severe AI. The different severity groups showed significantly different RF and it was possible to discriminate between clinical severity grades (P = 0.01).

Conclusion

ECHO and MRI showed good agreement in evaluating morphology and function of the left ventricle. The clinical severity of the disease can be evaluated correctly using MRI.
Literatur
1.
Zurück zum Zitat Tafreshi RI, Shahmohammadi A, Davari PN (2005) Predictors of left ventricular performance after valve replacement in children and adolescents with chronic aortic regurgitation. Pediatr Cardiol 26:331–337PubMedCrossRef Tafreshi RI, Shahmohammadi A, Davari PN (2005) Predictors of left ventricular performance after valve replacement in children and adolescents with chronic aortic regurgitation. Pediatr Cardiol 26:331–337PubMedCrossRef
2.
Zurück zum Zitat Wyttenbach R, Bremerich J, Saeed M et al (1998) Integrated MR imaging approach to valvular heart disease. Cardiol Clin 16:277–294PubMedCrossRef Wyttenbach R, Bremerich J, Saeed M et al (1998) Integrated MR imaging approach to valvular heart disease. Cardiol Clin 16:277–294PubMedCrossRef
3.
Zurück zum Zitat Thomas JD (2002) Doppler echocardiographic assessment of valvar regurgitation. Heart 88:651–657PubMedCrossRef Thomas JD (2002) Doppler echocardiographic assessment of valvar regurgitation. Heart 88:651–657PubMedCrossRef
4.
Zurück zum Zitat Didier D (2003) Assessment of valve disease: qualitative and quantitative. Magn Reson Imaging Clin N Am 11:115–134, viiPubMedCrossRef Didier D (2003) Assessment of valve disease: qualitative and quantitative. Magn Reson Imaging Clin N Am 11:115–134, viiPubMedCrossRef
5.
Zurück zum Zitat Quinones MA, Otto CM, Stoddard M et al (2002) Recommendations for quantification of Doppler echocardiography: a report from the Doppler Quantification Task Force of the Nomenclature and Standards Committee of the American Society of Echocardiography. J Am Soc Echocardiogr 15:167–184PubMedCrossRef Quinones MA, Otto CM, Stoddard M et al (2002) Recommendations for quantification of Doppler echocardiography: a report from the Doppler Quantification Task Force of the Nomenclature and Standards Committee of the American Society of Echocardiography. J Am Soc Echocardiogr 15:167–184PubMedCrossRef
6.
Zurück zum Zitat Bekeredjian R, Grayburn PA (2005) Valvular heart disease: aortic regurgitation. Circulation 112:125–134PubMedCrossRef Bekeredjian R, Grayburn PA (2005) Valvular heart disease: aortic regurgitation. Circulation 112:125–134PubMedCrossRef
7.
Zurück zum Zitat Kondo C, Caputo GR, Semelka R et al (1991) Right and left ventricular stroke volume measurements with velocity-encoded cine MR imaging: in vitro and in vivo validation. AJR 157:9–16PubMed Kondo C, Caputo GR, Semelka R et al (1991) Right and left ventricular stroke volume measurements with velocity-encoded cine MR imaging: in vitro and in vivo validation. AJR 157:9–16PubMed
8.
Zurück zum Zitat Rominger MB, Kluge A, Bachmann GF (2004) Biventricular MR volumetric analysis and MR flow quantification in the ascending aorta and pulmonary trunk for quantification of valvular regurgitation. Rofo 176:342–349PubMed Rominger MB, Kluge A, Bachmann GF (2004) Biventricular MR volumetric analysis and MR flow quantification in the ascending aorta and pulmonary trunk for quantification of valvular regurgitation. Rofo 176:342–349PubMed
9.
Zurück zum Zitat Honda N, Machida K, Hashimoto M et al (1993) Aortic regurgitation: quantitation with MR imaging velocity mapping. Radiology 186:189–194PubMed Honda N, Machida K, Hashimoto M et al (1993) Aortic regurgitation: quantitation with MR imaging velocity mapping. Radiology 186:189–194PubMed
10.
Zurück zum Zitat Gelfand EV, Hughes S, Hauser TH et al (2006) Severity of mitral and aortic regurgitation as assessed by cardiovascular magnetic resonance: optimizing correlation with Doppler echocardiography. J Cardiovasc Magn Reson 8:503–507PubMedCrossRef Gelfand EV, Hughes S, Hauser TH et al (2006) Severity of mitral and aortic regurgitation as assessed by cardiovascular magnetic resonance: optimizing correlation with Doppler echocardiography. J Cardiovasc Magn Reson 8:503–507PubMedCrossRef
11.
Zurück zum Zitat Engels G, Reynen K, Muller E et al (1993) Quantitative evaluation of aortic valve insufficiency in magnetic resonance tomography. Z Kardiol 82:345–351PubMed Engels G, Reynen K, Muller E et al (1993) Quantitative evaluation of aortic valve insufficiency in magnetic resonance tomography. Z Kardiol 82:345–351PubMed
12.
Zurück zum Zitat Devereux RB, Reichek N (1977) Echocardiographic determination of left ventricular mass in man. Anatomic validation of the method. Circulation 55:613–618PubMed Devereux RB, Reichek N (1977) Echocardiographic determination of left ventricular mass in man. Anatomic validation of the method. Circulation 55:613–618PubMed
13.
Zurück zum Zitat Silverman NH (1993) Pediatric echocardiography. Lippincott Williams & Wilkins, Philadelphia, pp 1–108 Silverman NH (1993) Pediatric echocardiography. Lippincott Williams & Wilkins, Philadelphia, pp 1–108
14.
Zurück zum Zitat Katz J, Milliken MC, Stray-Gundersen J et al (1988) Estimation of human myocardial mass with MR imaging. Radiology 169:495–498PubMed Katz J, Milliken MC, Stray-Gundersen J et al (1988) Estimation of human myocardial mass with MR imaging. Radiology 169:495–498PubMed
15.
Zurück zum Zitat Semelka R, Tomei E, Wagner S et al (1990) Normal left ventricular dimensions and function: interstudy reproducibility of measurements with cine MR imaging. Radiology 174:763–768PubMed Semelka R, Tomei E, Wagner S et al (1990) Normal left ventricular dimensions and function: interstudy reproducibility of measurements with cine MR imaging. Radiology 174:763–768PubMed
16.
Zurück zum Zitat Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1:307–310PubMed Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1:307–310PubMed
17.
Zurück zum Zitat Bonow RO, Carabello B, de Leon AC et al (1998) ACC/AHA guidelines for the management of patients with valvular heart disease. Executive summary. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Patients With Valvular Heart Disease). J Heart Valve Dis 7:672–707PubMed Bonow RO, Carabello B, de Leon AC et al (1998) ACC/AHA guidelines for the management of patients with valvular heart disease. Executive summary. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Patients With Valvular Heart Disease). J Heart Valve Dis 7:672–707PubMed
18.
Zurück zum Zitat Tornos P, Sambola A, Permanyer-Miralda G et al (2006) Long-term outcome of surgically treated aortic regurgitation: influence of guideline adherence toward early surgery. J Am Coll Cardiol 47:1012–1017PubMedCrossRef Tornos P, Sambola A, Permanyer-Miralda G et al (2006) Long-term outcome of surgically treated aortic regurgitation: influence of guideline adherence toward early surgery. J Am Coll Cardiol 47:1012–1017PubMedCrossRef
19.
Zurück zum Zitat Dujardin KS, Enriquez-Sarano M, Schaff HV et al (1999) Mortality and morbidity of aortic regurgitation in clinical practice. A long-term follow-up study. Circulation 99:1851–1857PubMed Dujardin KS, Enriquez-Sarano M, Schaff HV et al (1999) Mortality and morbidity of aortic regurgitation in clinical practice. A long-term follow-up study. Circulation 99:1851–1857PubMed
20.
Zurück zum Zitat Lung B, Gohlke-Barwolf C, Tornos P et al (2002) Recommendations on the management of the asymptomatic patient with valvular heart disease. Eur Heart J 23:1252–1266PubMed Lung B, Gohlke-Barwolf C, Tornos P et al (2002) Recommendations on the management of the asymptomatic patient with valvular heart disease. Eur Heart J 23:1252–1266PubMed
21.
Zurück zum Zitat Zoghbi WA, Enriquez-Sarano M, Foster E et al (2003) Recommendations for evaluation of the severity of native valvular regurgitation with two-dimensional and Doppler echocardiography. J Am Soc Echocardiogr 16:777–802PubMedCrossRef Zoghbi WA, Enriquez-Sarano M, Foster E et al (2003) Recommendations for evaluation of the severity of native valvular regurgitation with two-dimensional and Doppler echocardiography. J Am Soc Echocardiogr 16:777–802PubMedCrossRef
22.
Zurück zum Zitat Reimold SC, Maier SE, Aggarwal K et al (1996) Aortic flow velocity patterns in chronic aortic regurgitation: implications for Doppler echocardiography. J Am Soc Echocardiogr 9:675–683PubMedCrossRef Reimold SC, Maier SE, Aggarwal K et al (1996) Aortic flow velocity patterns in chronic aortic regurgitation: implications for Doppler echocardiography. J Am Soc Echocardiogr 9:675–683PubMedCrossRef
23.
Zurück zum Zitat Schwitter J (2000) Valvular heart disease: assessment of valve morphology and quantification using MR. Herz 25:342–355PubMedCrossRef Schwitter J (2000) Valvular heart disease: assessment of valve morphology and quantification using MR. Herz 25:342–355PubMedCrossRef
24.
Zurück zum Zitat Borer JS, Hochreiter C, Herrold EM et al (1998) Prediction of indications for valve replacement among asymptomatic or minimally symptomatic patients with chronic aortic regurgitation and normal left ventricular performance. Circulation 97:525–534PubMed Borer JS, Hochreiter C, Herrold EM et al (1998) Prediction of indications for valve replacement among asymptomatic or minimally symptomatic patients with chronic aortic regurgitation and normal left ventricular performance. Circulation 97:525–534PubMed
25.
Zurück zum Zitat Bellenger NG, Grothues F, Smith GC et al (2000) Quantification of right and left ventricular function by cardiovascular magnetic resonance. Herz 25:392–399PubMedCrossRef Bellenger NG, Grothues F, Smith GC et al (2000) Quantification of right and left ventricular function by cardiovascular magnetic resonance. Herz 25:392–399PubMedCrossRef
26.
Zurück zum Zitat Goldberg SJ, Allen HD (1985) Quantitative assessment by Doppler echocardiography of pulmonary or aortic regurgitation. Am J Cardiol 56:131–135PubMedCrossRef Goldberg SJ, Allen HD (1985) Quantitative assessment by Doppler echocardiography of pulmonary or aortic regurgitation. Am J Cardiol 56:131–135PubMedCrossRef
27.
Zurück zum Zitat Yeung AC, Plappert T, St John Sutton MG (1992) Calculation of aortic regurgitation orifice area by Doppler echocardiography: an application of the continuity equation. Br Heart J 68:236–240PubMed Yeung AC, Plappert T, St John Sutton MG (1992) Calculation of aortic regurgitation orifice area by Doppler echocardiography: an application of the continuity equation. Br Heart J 68:236–240PubMed
28.
Zurück zum Zitat Mathison M, Furuse A, Asano K (1988) Doppler analysis of flow velocity profile at the aortic root. J Am Coll Cardiol 12:947–954PubMedCrossRef Mathison M, Furuse A, Asano K (1988) Doppler analysis of flow velocity profile at the aortic root. J Am Coll Cardiol 12:947–954PubMedCrossRef
29.
Zurück zum Zitat Segadal L (1991) Velocity distribution model for normal blood flow in the human ascending aorta. Med Biol Eng Comput 29:489–492PubMedCrossRef Segadal L (1991) Velocity distribution model for normal blood flow in the human ascending aorta. Med Biol Eng Comput 29:489–492PubMedCrossRef
30.
Zurück zum Zitat Sondergaard L, Lindvig K, Hildebrandt P et al (1993) Quantification of aortic regurgitation by magnetic resonance velocity mapping. Am Heart J 125:1081–1090PubMedCrossRef Sondergaard L, Lindvig K, Hildebrandt P et al (1993) Quantification of aortic regurgitation by magnetic resonance velocity mapping. Am Heart J 125:1081–1090PubMedCrossRef
31.
Zurück zum Zitat Didier D, Ratib O, Lerch R et al (2000) Detection and quantification of valvular heart disease with dynamic cardiac MR imaging. Radiographics 20:1279–1299; discussion 1299–1301PubMed Didier D, Ratib O, Lerch R et al (2000) Detection and quantification of valvular heart disease with dynamic cardiac MR imaging. Radiographics 20:1279–1299; discussion 1299–1301PubMed
32.
Zurück zum Zitat Chatzimavroudis GP, Oshinski JN, Franch RH et al (1998) Quantification of the aortic regurgitant volume with magnetic resonance phase velocity mapping: a clinical investigation of the importance of imaging slice location. J Heart Valve Dis 7: 94–101PubMed Chatzimavroudis GP, Oshinski JN, Franch RH et al (1998) Quantification of the aortic regurgitant volume with magnetic resonance phase velocity mapping: a clinical investigation of the importance of imaging slice location. J Heart Valve Dis 7: 94–101PubMed
Metadaten
Titel
Evaluation of aortic regurgitation in congenital heart disease: value of MR imaging in comparison to echocardiography
verfasst von
Sebastian Ley
Joachim Eichhorn
Julia Ley-Zaporozhan
Herbert Ulmer
Jens-Peter Schenk
Hans-Ulrich Kauczor
Raoul Arnold
Publikationsdatum
01.05.2007
Verlag
Springer-Verlag
Erschienen in
Pediatric Radiology / Ausgabe 5/2007
Print ISSN: 0301-0449
Elektronische ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-007-0414-4

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