Skip to main content
Erschienen in: European Radiology 9/2016

03.12.2015 | Cardiac

Quantitating aortic regurgitation by cardiovascular magnetic resonance: significant variations due to slice location and breath holding

verfasst von: Abhishek Chaturvedi, Christian Hamilton-Craig, Peter J. Cawley, Lee M. Mitsumori, Catherine M. Otto, Jeffrey H. Maki

Erschienen in: European Radiology | Ausgabe 9/2016

Einloggen, um Zugang zu erhalten

Abstract

Objectives

Compare variability in flow measurements by phase contrast MRI, performed at different locations in the aorta and pulmonary artery (PA) using breath-held (BH) and free-breathing (FB) sequences.

Methods

Fifty-seven patients with valvular heart disease, confirmed by echocardiography, were scanned using BH technique at 3 locations in the ascending aorta (SOV = sinus of Valsalva, STJ = sinotubular junction, ASC = ascending aorta at level of right pulmonary artery) and 2 locations in PA. Single FB measurement was obtained at STJ for aorta. Obtained metrics (SV = stroke volume, FV = forward volume, BV = backward volume, RF = regurgitant fraction) were evaluated separately for patients with aortic regurgitation (AR, n = 31) and mitral regurgitation (n = 26).

Results

No difference was noted between the two measurements in the PA. Significant differences were noted in measured SV at different aortic locations. SV measurements obtained at ASC correlated best with the measurements obtained in the PA. Strongest correlation of AR was measured at the STJ.

Conclusion

Measurements of flow volumes by phase contrast MRI differ depending on slice location. When using stroke volumes to calculate pulmonary to systemic blood flow ratio (Qp/Qs), ASC should be used. For quantifying aortic regurgitation, measurement should be obtained at STJ.

Key Points

• Aortic regurgitation can be accurately measured by MRI.
• Aortic regurgitation measurement by MRI varies according to the location where measured.
• Aortic regurgitation can also be measured by MRI without breath hold.
Literatur
1.
Zurück zum Zitat Kramer CM (ed) (2010) Multimodality imaging in cardiovascular medicine. Demos Medical, New York Kramer CM (ed) (2010) Multimodality imaging in cardiovascular medicine. Demos Medical, New York
2.
Zurück zum Zitat Kutty S, Whitehead KK, Natarajan S, Harris MA, Wernovsky G, Fogel MA (2009) Qualitative echocardiographic assessment of aortic valve regurgitation with quantitative cardiac magnetic resonance: a comparative study. Pediatr Cardiol 30:971–977CrossRefPubMed Kutty S, Whitehead KK, Natarajan S, Harris MA, Wernovsky G, Fogel MA (2009) Qualitative echocardiographic assessment of aortic valve regurgitation with quantitative cardiac magnetic resonance: a comparative study. Pediatr Cardiol 30:971–977CrossRefPubMed
3.
Zurück zum Zitat Cawley PJ, Otto CM (2009) Valvular regurgitation: does cardiovascular magnetic resonance provide additional information compared to echocardiography? Minerva Cardioangiol 57:521–535PubMed Cawley PJ, Otto CM (2009) Valvular regurgitation: does cardiovascular magnetic resonance provide additional information compared to echocardiography? Minerva Cardioangiol 57:521–535PubMed
4.
Zurück zum Zitat Kozerke S, Scheidegger MB, Pedersen EM, Boesiger P (1999) Heart motion adapted cine phase-contrast flow measurements through the aortic valve. Magn Reson Med 42:970–978CrossRefPubMed Kozerke S, Scheidegger MB, Pedersen EM, Boesiger P (1999) Heart motion adapted cine phase-contrast flow measurements through the aortic valve. Magn Reson Med 42:970–978CrossRefPubMed
5.
Zurück zum Zitat Cawley PJ, Hamilton-Craig C, Owens DS et al (2013) Prospective comparison of valve regurgitation quantitation by cardiac magnetic resonance imaging and transthoracic echocardiography. Circ Cardiovasc Imaging 6:48–57CrossRefPubMed Cawley PJ, Hamilton-Craig C, Owens DS et al (2013) Prospective comparison of valve regurgitation quantitation by cardiac magnetic resonance imaging and transthoracic echocardiography. Circ Cardiovasc Imaging 6:48–57CrossRefPubMed
6.
Zurück zum Zitat Myerson SG, d'Arcy J, Mohiaddin R et al (2012) Aortic regurgitation quantification using cardiovascular magnetic resonance: association with clinical outcome. Circulation 126:1452–1460CrossRefPubMed Myerson SG, d'Arcy J, Mohiaddin R et al (2012) Aortic regurgitation quantification using cardiovascular magnetic resonance: association with clinical outcome. Circulation 126:1452–1460CrossRefPubMed
7.
Zurück zum Zitat Chatzimavroudis GP, Walker PG, Oshinski JN, Franch RH, Pettigrew RI, Yoganathan AP (1997) Slice location dependence of aortic regurgitation measurements with MR phase velocity mapping. Magn Reson Med 37:545–551CrossRefPubMed Chatzimavroudis GP, Walker PG, Oshinski JN, Franch RH, Pettigrew RI, Yoganathan AP (1997) Slice location dependence of aortic regurgitation measurements with MR phase velocity mapping. Magn Reson Med 37:545–551CrossRefPubMed
8.
Zurück zum Zitat Devos DG, Kilner PJ (2010) Calculations of cardiovascular shunts and regurgitation using magnetic resonance ventricular volume and aortic and pulmonary flow measurements. Eur Radiol 20:410–421CrossRefPubMed Devos DG, Kilner PJ (2010) Calculations of cardiovascular shunts and regurgitation using magnetic resonance ventricular volume and aortic and pulmonary flow measurements. Eur Radiol 20:410–421CrossRefPubMed
9.
Zurück zum Zitat Pouleur AC, le Polain de Waroux JB, Goffinet C et al (2008) Accuracy of the flow convergence method for quantification of aortic regurgitation in patients with central versus eccentric jets. Am J Cardiol 102:475–480CrossRefPubMed Pouleur AC, le Polain de Waroux JB, Goffinet C et al (2008) Accuracy of the flow convergence method for quantification of aortic regurgitation in patients with central versus eccentric jets. Am J Cardiol 102:475–480CrossRefPubMed
10.
Zurück zum Zitat Bogren HG, Buonocore MH (1999) Complex flow patterns in the great vessels: a review. Int J Card Imaging 15:105–113CrossRefPubMed Bogren HG, Buonocore MH (1999) Complex flow patterns in the great vessels: a review. Int J Card Imaging 15:105–113CrossRefPubMed
11.
Zurück zum Zitat Honda N, Machida K, Hashimoto M et al (1993) Aortic regurgitation: quantitation with MR imaging velocity mapping. Radiology 186:189–194CrossRefPubMed Honda N, Machida K, Hashimoto M et al (1993) Aortic regurgitation: quantitation with MR imaging velocity mapping. Radiology 186:189–194CrossRefPubMed
12.
Zurück zum Zitat Kilner PJ, Gatehouse PD, Firmin DN (2007) Flow measurement by magnetic resonance: a unique asset worth optimising. J Cardiovasc Magn Reson 9:723–728CrossRefPubMed Kilner PJ, Gatehouse PD, Firmin DN (2007) Flow measurement by magnetic resonance: a unique asset worth optimising. J Cardiovasc Magn Reson 9:723–728CrossRefPubMed
13.
Zurück zum Zitat Laffon E, Galy-Lacour C, Laurent F, Ducassou D, Marthan R (2003) MRI quantification of the role of the reflected pressure wave on coronary and ascending aortic blood flow. Physiol Meas 24:681–692CrossRefPubMed Laffon E, Galy-Lacour C, Laurent F, Ducassou D, Marthan R (2003) MRI quantification of the role of the reflected pressure wave on coronary and ascending aortic blood flow. Physiol Meas 24:681–692CrossRefPubMed
14.
Zurück zum Zitat Wittlinger T, Dzemali O, Bakhtiary F, Moritz A, Kleine P (2008) Hemodynamic evaluation of aortic regurgitation by magnetic resonance imaging. Asian Cardiovasc Thorac Ann 16:278–283CrossRefPubMed Wittlinger T, Dzemali O, Bakhtiary F, Moritz A, Kleine P (2008) Hemodynamic evaluation of aortic regurgitation by magnetic resonance imaging. Asian Cardiovasc Thorac Ann 16:278–283CrossRefPubMed
15.
Zurück zum Zitat Baltes C, Hansen MS, Tsao J et al (2008) Determination of peak velocity in stenotic areas: echocardiography versus k-t SENSE accelerated MR Fourier velocity encoding. Radiology 246:249–257CrossRefPubMed Baltes C, Hansen MS, Tsao J et al (2008) Determination of peak velocity in stenotic areas: echocardiography versus k-t SENSE accelerated MR Fourier velocity encoding. Radiology 246:249–257CrossRefPubMed
16.
Zurück zum Zitat Bonow RO, Carabello BA, Chatterjee K et al (2006) ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to revise the 1998 guidelines for the management of patients with valvular heart disease) developed in collaboration with the Society of Cardiovascular Anesthesiologists endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons. J Am Coll Cardiol 48:e1–148CrossRefPubMed Bonow RO, Carabello BA, Chatterjee K et al (2006) ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to revise the 1998 guidelines for the management of patients with valvular heart disease) developed in collaboration with the Society of Cardiovascular Anesthesiologists endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons. J Am Coll Cardiol 48:e1–148CrossRefPubMed
17.
Zurück zum Zitat Shin HJ, Shin JK, Chee HK, Kim JS, Ko SM (2015) Characteristics of aortic valve dysfunction and ascending aorta dimensions according to bicuspid aortic valve morphology. Eur Radiol 25:2103–2114CrossRefPubMed Shin HJ, Shin JK, Chee HK, Kim JS, Ko SM (2015) Characteristics of aortic valve dysfunction and ascending aorta dimensions according to bicuspid aortic valve morphology. Eur Radiol 25:2103–2114CrossRefPubMed
18.
Zurück zum Zitat Detaint D, Messika-Zeitoun D, Maalouf J et al (2008) Quantitative echocardiographic determinants of clinical outcome in asymptomatic patients with aortic regurgitation: a prospective study. JACC Cardiovasc Imaging 1:1–11CrossRefPubMed Detaint D, Messika-Zeitoun D, Maalouf J et al (2008) Quantitative echocardiographic determinants of clinical outcome in asymptomatic patients with aortic regurgitation: a prospective study. JACC Cardiovasc Imaging 1:1–11CrossRefPubMed
19.
Zurück zum Zitat Croft CH, Lipscomb K, Mathis K et al (1984) Limitations of qualitative angiographic grading in aortic or mitral regurgitation. Am J Cardiol 53:1593–1598CrossRefPubMed Croft CH, Lipscomb K, Mathis K et al (1984) Limitations of qualitative angiographic grading in aortic or mitral regurgitation. Am J Cardiol 53:1593–1598CrossRefPubMed
20.
Zurück zum Zitat Dahiya A, Bolen M, Grimm RA, Rodriguez LL, Thomas JD, Marwick TH (2012) Development of a consensus document to improve multireader concordance and accuracy of aortic regurgitation severity grading by echocardiography versus cardiac magnetic resonance imaging. Am J Cardiol 110:709–714CrossRefPubMed Dahiya A, Bolen M, Grimm RA, Rodriguez LL, Thomas JD, Marwick TH (2012) Development of a consensus document to improve multireader concordance and accuracy of aortic regurgitation severity grading by echocardiography versus cardiac magnetic resonance imaging. Am J Cardiol 110:709–714CrossRefPubMed
21.
Zurück zum Zitat Goffinet C, Kersten V, Pouleur AC et al (2010) Comprehensive assessment of the severity and mechanism of aortic regurgitation using multidetector CT and MR. Eur Radiol 20:326–336CrossRefPubMed Goffinet C, Kersten V, Pouleur AC et al (2010) Comprehensive assessment of the severity and mechanism of aortic regurgitation using multidetector CT and MR. Eur Radiol 20:326–336CrossRefPubMed
22.
Zurück zum Zitat Sakuma H, Kawada N, Kubo H et al (2001) Effect of breath holding on blood flow measurement using fast velocity encoded cine MRI. Magn Reson Med 45:346–348CrossRefPubMed Sakuma H, Kawada N, Kubo H et al (2001) Effect of breath holding on blood flow measurement using fast velocity encoded cine MRI. Magn Reson Med 45:346–348CrossRefPubMed
23.
Zurück zum Zitat Hall JE, Guyton AC (2011) Coronary circulation, Chap. 21. In: Guyton and Hall textbook of medical physiology. Saunders/Elsevier, Philadelphia, pp xix, 1091 p Hall JE, Guyton AC (2011) Coronary circulation, Chap. 21. In: Guyton and Hall textbook of medical physiology. Saunders/Elsevier, Philadelphia, pp xix, 1091 p
24.
Zurück zum Zitat Reid SA, Walker PG, Fisher J et al (2002) The quantification of pulmonary valve haemodynamics using MRI. Int J Cardiovasc Imaging 18:217–225CrossRefPubMed Reid SA, Walker PG, Fisher J et al (2002) The quantification of pulmonary valve haemodynamics using MRI. Int J Cardiovasc Imaging 18:217–225CrossRefPubMed
25.
Zurück zum Zitat Rahman EA, Koshy M, Neill J et al (2014) Quantitation of pulmonary regurgitation in repaired tetralogy of Fallot by cardiac magnetic resonance – it matters where you measure! Global Heart 9:e143–144CrossRef Rahman EA, Koshy M, Neill J et al (2014) Quantitation of pulmonary regurgitation in repaired tetralogy of Fallot by cardiac magnetic resonance – it matters where you measure! Global Heart 9:e143–144CrossRef
26.
Zurück zum Zitat Markl M, Frydrychowicz A, Kozerke S, Hope M, Wieben O (2012) 4D flow MRI. J Magn Reson Imaging 36:1015–1036CrossRefPubMed Markl M, Frydrychowicz A, Kozerke S, Hope M, Wieben O (2012) 4D flow MRI. J Magn Reson Imaging 36:1015–1036CrossRefPubMed
27.
Zurück zum Zitat Gatehouse PD, Rolf MP, Graves MJ et al (2010) Flow measurement by cardiovascular magnetic resonance: a multi-centre multi-vendor study of background phase offset errors that can compromise the accuracy of derived regurgitant or shunt flow measurements. J Cardiovasc Magn Reson 12:5CrossRefPubMedPubMedCentral Gatehouse PD, Rolf MP, Graves MJ et al (2010) Flow measurement by cardiovascular magnetic resonance: a multi-centre multi-vendor study of background phase offset errors that can compromise the accuracy of derived regurgitant or shunt flow measurements. J Cardiovasc Magn Reson 12:5CrossRefPubMedPubMedCentral
Metadaten
Titel
Quantitating aortic regurgitation by cardiovascular magnetic resonance: significant variations due to slice location and breath holding
verfasst von
Abhishek Chaturvedi
Christian Hamilton-Craig
Peter J. Cawley
Lee M. Mitsumori
Catherine M. Otto
Jeffrey H. Maki
Publikationsdatum
03.12.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 9/2016
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-015-4120-6

Weitere Artikel der Ausgabe 9/2016

European Radiology 9/2016 Zur Ausgabe

Endlich: Zi zeigt, mit welchen PVS Praxen zufrieden sind

IT für Ärzte Nachrichten

Darauf haben viele Praxen gewartet: Das Zi hat eine Liste von Praxisverwaltungssystemen veröffentlicht, die von Nutzern positiv bewertet werden. Eine gute Grundlage für wechselwillige Ärzte und Psychotherapeuten.

Akuter Schwindel: Wann lohnt sich eine MRT?

28.04.2024 Schwindel Nachrichten

Akuter Schwindel stellt oft eine diagnostische Herausforderung dar. Wie nützlich dabei eine MRT ist, hat eine Studie aus Finnland untersucht. Immerhin einer von sechs Patienten wurde mit akutem ischämischem Schlaganfall diagnostiziert.

Screening-Mammografie offenbart erhöhtes Herz-Kreislauf-Risiko

26.04.2024 Mammografie Nachrichten

Routinemäßige Mammografien helfen, Brustkrebs frühzeitig zu erkennen. Anhand der Röntgenuntersuchung lassen sich aber auch kardiovaskuläre Risikopatientinnen identifizieren. Als zuverlässiger Anhaltspunkt gilt die Verkalkung der Brustarterien.

S3-Leitlinie zu Pankreaskrebs aktualisiert

23.04.2024 Pankreaskarzinom Nachrichten

Die Empfehlungen zur Therapie des Pankreaskarzinoms wurden um zwei Off-Label-Anwendungen erweitert. Und auch im Bereich der Früherkennung gibt es Aktualisierungen.

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.