Low-field magnetic resonance imaging in the evaluation of mechanical and biological heart valve function

Cesare, Ernesto Di; Enrici, Riccardo Maurizi; S, Paparoni; Castaldo, F; Alagia, Maria Gabriella; Splendiani, Alessandra; Bottone, Alessio; Lupattelli, L

doi:10.1016/0720-048x(95)00656-b

Cited by 19 publications

(9 citation statements)

References 8 publications

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“…3–5 Similarly, phase contrast CMR imaging is well validated for assessment of native valvular regurgitation, 10, 11 but can be compromised by localized field disturbances as can be produced by prosthetic materials. 19, 20 Of course, prosthetic materials within both bio- and mechanical mitral valves can produce susceptibility artifacts due to localized changes in magnetic field homogeneity, 21, 22 prohibiting direct cine-CMR evaluation of valve morphology and obscuring small amounts of regurgitant flow. However, our results demonstrate that such localized disturbances do not typically interfere with assessment of substantial (i.e.…”

Section: Discussionmentioning

confidence: 99%

Routine Cine-CMR for Prosthesis Associated Mitral Regurgitation: A Multicenter Comparison to Echocardiography

Simprini

Afroz

Klem

et al. 2013

Journal of the American College of Cardiology

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Background/Aim MR is an important complication after PMV. Transthoracic echocardiography is widely used to screen for native MR, but can be limited with PMV. Cine-CMR holds potential to non-invasively assess regurgitant severity based on MR-induced inter-voxel dephasing. This study evaluated routine cine-CMR for visual assessment of prosthetic mitral valve (PMV) associated mitral regurgitation (MR). Methods Routine cine-CMR was performed at 9 sites. A uniform protocol was used to grade MR based on jet size in relation to the left atrium (mild <1/3, moderate 1/3–2/3, severe >2/3): MR was graded in each long axis orientation, with overall severity based on cumulative grade. Cine-CMR was also scored for MR density and pulmonary vein systolic flow reversal (PSFR). Visual interpretation was compared to quantitative analysis in a single center (derivation) cohort, and to transesophageal echocardiography (TEE) in a multicenter (validation) cohort. Results The population comprised 85 PMV patients (59% mechanical, 41% bioprosthetic). Among the derivation cohort (n=25), quantitative indices paralleled visual scores, with stepwise increases in jet size and density in relation to visually graded MR severity (both p=0.001): Patients with severe MR had nearly a 3-fold increase in quantitative jet area (p=0.002), and 2-fold increase in density (p=0.04) than did others. Among the multicenter cohort, cine-CMR and TEE (Δ=2±3 days) demonstrated moderate agreement (κ=0.44); 64% of discordances differed by ≤ 1 grade (Δ=1.2±0.5). Using a TEE reference, cine-CMR yielded excellent diagnostic performance for severe MR (sensitivity, negative predictive value=100%). Patients with visually graded severe MR also had more frequent PVSFR (p<0.001), denser jets (p<0.001), and larger left atria (p=0.01) on cine-CMR. Conclusions Cine-CMR is useful for assessment of PMV-associated MR, which manifests concordant quantitative and qualitative changes in size and density of inter-voxel dephasing. Visual MR assessment based on jet size provides an accurate non-invasive means of screening for TEE-evidenced severe MR.

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Section: Discussionmentioning

confidence: 99%

Routine Cine-CMR for Prosthesis Associated Mitral Regurgitation: A Multicenter Comparison to Echocardiography

Simprini

Afroz

Klem

et al. 2013

Journal of the American College of Cardiology

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“…Metallic heart valves are therefore visible as dark areas surrounded by bright-blood. Nevertheless, in a majority of cases qualitative analysis of the valve function and accurate measurement of the blood velocity downstream of the prosthetic heart valve can be performed (Di Cesare et al 1995;Walker et al 1995). Physiologic valvular regurgitation can be differentiated from pathologic or valvular regurgitation.…”

Section: Prosthetic Valves and Other Foreign Devicesmentioning

confidence: 98%

Cardiac Masses

Bogaert¹,

Dymarkowski²

2011

Clinical Cardiac MRI

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“…By the use of acquisition through the outflow ventricular tract and parallel to the aortic annulus, it is possible to detect the presence of turbulent flow and leaflet defects. Moreover, using Gradient Encoding sequences it is possible to evaluate the velocity through the valve and calculate the pressure gradient or regurgitant volume [ 20 ].…”

Section: Magentic Resonance Imaging (Mri)mentioning

confidence: 99%

CT and MR imaging of the thoracic aorta

et al. 2016

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AbstractAt present time, both CT and MRI are valuable techniques in the study of the thoracic aorta. Nowadays, CT represents the most widely employed technique for the study of the thoracic aorta. The new generation CTs show sensitivities up to 100% and specificities of 98-99%. Sixteen and wider row detectors provide isotropic pixels, mandatory for the ineludible longitudinal reconstruction. The main limits are related to the X-ray dose expoure and the use of iodinated contrast media. MRI has great potential in the study of the thoracic aorta. Nevertheless, if compared to CT, acquisition times remain longer and movement artifact susceptibility higher. The main MRI disadvantages are claustrophobia, presence of ferromagnetic implants, pacemakers, longer acquisition times with respect to CT, inability to use contrast media in cases of renal insufficiency, lower spatial resolution and less availability than CT. CT is preferred in the acute aortic disease. Nevertheless, since it requires iodinated contrast media and X-ray exposure, it may be adequately replaced by MRI in the follow up of aortic diseases. The main limitation of MRI, however, is related to the scarce visibility of stents and calcifications.

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Low-field magnetic resonance imaging in the evaluation of mechanical and biological heart valve function

Cited by 19 publications

References 8 publications

Routine Cine-CMR for Prosthesis Associated Mitral Regurgitation: A Multicenter Comparison to Echocardiography

Routine Cine-CMR for Prosthesis Associated Mitral Regurgitation: A Multicenter Comparison to Echocardiography

Cardiac Masses

CT and MR imaging of the thoracic aorta

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