Diagnosis of Patent Foramen Ovale Using Contrast-Enhanced Dynamic MRI: A Pilot Study

Mohrs, Oliver K.; Petersen, Steffen E.; Erkapic, Damir; Rubel, C; Schräder, Rainer; Nowak, Bernd; Fach, W. A.; Kauczor, Hans‐Ulrich; Voigtlaender, Thomas

doi:10.2214/ajr.184.1.01840234

Cited by 63 publications

(27 citation statements)

References 25 publications

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“…[1][2][3][4] Efficacy has been addressed by evidence of PFO closure determined in transthoracic echocardiography, transesophageal echocardiography (TEE), [3][4][5] and cardiac magnetic resonance imaging (CMRI). 5,6 During long-term follow-up, recurrence of ischemic events such as stroke, transient ischemic event, or peripheral emboli has been analyzed. 2,3,7 With respect to safety complications during device implantation, 2 atrial erosion 8 and thrombus formation on the device 4 were the focus.…”

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confidence: 99%

Impact of Percutaneous Device Implantation for Closure of Patent Foramen Ovale on Valve Insufficiencies

et al. 2009

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Background-In patients with percutaneous device implantation for closure of patent foramen ovale (PFO), a 10% incidence of new or worsened aortic regurgitation within 12 months has been reported with echocardiography. Cardiac magnetic resonance imaging is a powerful noninvasive tool to quantify volume and fraction of valve insufficiencies. We studied the acute and long-term impact of percutaneous device implantation for PFO closure on valve insufficiencies in cardiac magnetic resonance imaging. Methods and Results-Sequential cardiac magnetic resonance imaging studies were performed in 102 patients with cryptogenic ischemic events. Cardiac magnetic resonance imaging was performed before PFO closure, the day after device implantation, and at 12 months of follow-up. There was no difference in volumetric and hemodynamic parameters before PFO closure compared with 12 months of follow-up. With a cutoff for relevant regurgitation fraction of 5%, there were no statistically significant differences in regurgitation fraction of the semilunar and atrioventricular valves. The median fraction of aortic valve insufficiency was 3.9% (interquartile range [IQR] 2.0% to 5.1%) before PFO closure, 5.4% (IQR 4.1% to 5.9%) after device implantation, and 4.3% (IQR 3.3% to 6.0%) at 12 months of follow-up. The size and type of the occluder had no impact on aortic valve insufficiency. Median regurgitation fraction for the pulmonary valve was 3.6% (IQR 2.4% to 6.7%) before intervention, 7.3% (IQR 5.1% to 8.2%) after occluder implantation and 5.8% (IQR 4.8% to 7.4%) at 12 months of follow-up. Values for the mitral valve were 3.1% (IQR 1.4% to 6.0%), 5.5% (IQR 3.5% to 7.3%), and 3.8% (IQR 1.5% to 7.9%) and for the tricuspid valve were 5.4% (IQR 0.1% to 8.8%), 5.8% (IQR 1.4% to 9.2%), and 6.0% (IQR 1.1% to 8.4%), respectively. Conclusions-Percutaneous

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confidence: 99%

Impact of Percutaneous Device Implantation for Closure of Patent Foramen Ovale on Valve Insufficiencies

et al. 2009

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“…Magnetic resonance imaging after transcatheter closure of PFO is feasible and enables evaluation of patients after interventional closure with a noninvasive imaging modality (2). Recently, in a small population of 20 patients, a 100% concordance with CMRI and TEE in detection of PFO and atrial septal aneurysm (ASA) was reported (3). The value of CMRI compared with TEE in patients undergoing transcatheter PFO closure has not been addressed so far.…”

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confidence: 99%

Cardiac Magnetic Resonance Imaging and Transesophageal Echocardiography in Patients With Transcatheter Closure of Patent Foramen Ovale

Nusser

Höher

Merkle

et al. 2006

Journal of the American College of Cardiology

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“…The annual recurrence rate of thromboembolic disease for patients with patent foramen ovale is about 3.5% [37]. Thus, detection of patent foramen ovale is crucial in the management of patients with thromboembolic disease and must be achieved with MRI before transesophageal echocardiography might be replaced [38]. Even in this small study group patent foramen ovale was found in two patients by echocardiography.…”

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confidence: 70%

Combined arterial and venous whole-body MR angiography with cardiac MR imaging in patients with thromboembolic disease—initial experience

et al. 2008

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The objective was to assess the feasibility of a combined arterial and venous whole-body three-dimensional magnetic resonance (MR) angiography, together with a cardiac MR examination, in patients with arterial thromboembolism. Ten patients with arterial thromboembolism underwent a contrast-enhanced whole-body MR examination of the arterial and venous vessels, followed by a cardiac MR examination on a separate occasion within 24 h. All examinations were performed on a 1.5-T MR scanner. For both arterial and venous MR angiography only one injection of contrast agent was necessary. The cardiac imaging protocol included dark-blood-prepared half-Fourier acquisition single-shot turbo-spin-echo sequences, fast steady-state free precession cine sequences, T2-weighted turbo-spin-echo sequences and inversion recovery gradient-echo fast low-angle-shot sequences after injection of contrast agent. MR imaging revealed additional clinically unknown arterial thromboembolisms in four patients. The thoracic aorta was depicted as embolic source in four patients, while deep vein thrombosis (DVT) was found in one patient as the underlying disease. Unsuspected infarction of parenchymal organs was detected by MRI in two patients. An unknown additional DVT was found in one patient. Four patients were considered to have arterial emboli of cardiac origin. In conclusion, acquisition of arterial and venous MR angiograms of the entire vascular system combined with cardiac MR imaging is a most comprehensive and valuable strategy in patients with arterial thromboembolism.

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Diagnosis of Patent Foramen Ovale Using Contrast-Enhanced Dynamic MRI: A Pilot Study

Abstract: This pilot study shows that MRI is a new noninvasive method to detect patent foramen ovale and atrial septal aneurysm. A grading is possible but warrants further investigation regarding its predictive value and impact on treatment strategies.

Cited by 63 publications

References 25 publications

Impact of Percutaneous Device Implantation for Closure of Patent Foramen Ovale on Valve Insufficiencies

Impact of Percutaneous Device Implantation for Closure of Patent Foramen Ovale on Valve Insufficiencies

Cardiac Magnetic Resonance Imaging and Transesophageal Echocardiography in Patients With Transcatheter Closure of Patent Foramen Ovale

Combined arterial and venous whole-body MR angiography with cardiac MR imaging in patients with thromboembolic disease—initial experience

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