Magnetic resonance imaging in valvular heart disease: Clinical application and current role for patient management

Sommer, Gregor; Bremerich, Jens; Lund, Gunnar

doi:10.1002/jmri.23544

Cited by 23 publications

(12 citation statements)

References 90 publications

(75 reference statements)

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“…(64) The regurgitant fraction for each valve can be determined which is a major advantage of this method. (64) The issue of estimating the mPAP from tricuspid regurgitant jet velocity measurements with phase contrast MRA is not that the jet velocity can’t be measured, so much as it is that the modified Bernoulli equation itself has limitations for PAP estimation as has been previously discussed.…”

Section: Mr Measurement Of Tricuspid and Pulmonic Valvular Regurgitationmentioning

confidence: 99%

Magnetic Resonance and Computed Tomography Imaging of the Structural and Functional Changes of Pulmonary Arterial Hypertension

Schiebler

Bhalla

Runo

et al. 2013

Journal of Thoracic Imaging

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The current Dana Point classification system (2009) divides elevation of pulmonary artery pressure into Pulmonary Arterial Hypertension (PAH) and Pulmonary Hypertension (PH). Fortunately, pulmonary arterial hypertension (PAH) is not a common disease. However, with the aging of the first world’s population, heart failure is now an important cause of pulmonary hypertension with up to 9% of the population involved. PAH is usually asymptomatic until late in the disease process. While there are indirect features of PAH found on noninvasive imaging studies, the diagnosis and management still requires right heart catheterization. Imaging features of PAH include: 1. Enlargement of the pulmonary trunk and main pulmonary arteries, 2. Decreased pulmonary arterial compliance, 3. Tapering of the peripheral pulmonary arteries, 4. Enlargement of the inferior vena cava, and 5. Increased mean transit time. The chronic requirement to generate high pulmonary arterial pressures measurably affects the right heart and main pulmonary artery. This change in physiology causes the following structural and functional alterations that have been shown to have prognostic significance: Relative area change of the pulmonary trunk, RVSVindex, RVSV, RVEDVindex, LVEDVindex, and baseline RVEF <35%. All of these variables can be quantified non-invasively and followed longitudinally in each patient using MRI to modify the treatment regimen. Untreated PAH frequently results in a rapid clinical decline and death within 3 years of diagnosis. Unfortunately, even with treatment, less than 1/2 of these patients are alive at four years.

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Section: Mr Measurement Of Tricuspid and Pulmonic Valvular Regurgitationmentioning

confidence: 99%

Magnetic Resonance and Computed Tomography Imaging of the Structural and Functional Changes of Pulmonary Arterial Hypertension

Schiebler

Bhalla

Runo

et al. 2013

Journal of Thoracic Imaging

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“…Another limitation of cine SSFP imaging is sensitivity to arrhythmias, as ECG-gating is used to combine data over multiple successive heartbeats. There are also older sequences that can be used to assess valve anatomy, such as “black blood” turbo-spin-echo (TSE) techniques [5, 13]. T1-weighted and T2-weighted TSE imaging techniques have been used for the assessment of valvular masses or vegetations [14–16].…”

Section: Mri Techniques For Valvular Assessment and Flow Quantificationmentioning

confidence: 99%

“…Magnetic spins, moving along the direction of a magnetic gradient, acquire phase shifts depending on the velocity of the spin. In the case of turbulent flow, there are spins with different phase shifts leading to dephasing of the net magnetization and signal loss that is more easily seen in gradient echo imaging (GRE) [5, 21]. Cine GRE is an older CMR “bright blood” cine imaging technique which has reduced myocardial-blood contrast, lower signal-to-noise ratio, and longer acquisition times compared to SSFP (Fig.…”

Section: Mri Techniques For Valvular Assessment and Flow Quantificationmentioning

confidence: 99%

Role of Cardiac Magnetic Resonance Imaging in Valvular Heart Disease: Diagnosis, Assessment, and Management

2018

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Purpose of Review This article will review the current techniques in cardiac magnetic resonance imaging (CMR) for diagnosing and assessing primary valvular heart disease. Recent Findings The recent advancements in CMR have led to an increased role of this modality for qualifying and quantifying various native valve diseases. Phase-contrast velocity encoded imaging is a well-established technique that can be used to quantify aortic and pulmonic flow. This technique, combined with the improved ability for CMR to obtain accurate left and right ventricular volumetrics, has allowed for increased accuracy and reproducibility in assessing valvular dysfunction. Advancements in CMR technology also allows for improved spatial and temporal resolution imaging of various valves and their regurgitant or stenotic jets. Therefore, CMR can be a powerful tool in evaluation of native valvular heart disease. Summary The role of CMR in assessing valvular heart disease is growing and being recognized in recent guidelines. CMR has the ability to assess valve morphology along with qualifying and quantifying valvular disease. In addition, the ability to obtain accurate volumetric measurements may improve more precise management strategies and may lead to improvements in mortality and morbidity.

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“…Noninvasive quantification of a severe TR jet has limitations. Cine MRI provides several measurements, including the area, volume, and maximum length of the signal intensity void; and the ratio of the signal intensity void area to the area of the right atrium [66].…”

Section: Imaging Evaluation Of Tricuspid Valvementioning

confidence: 99%

Imaging Evaluation of Tricuspid Valve: Analysis of Morphology and Function With CT and MRI

Saremi

Hassani

Millan-Nunez

et al. 2015

American Journal of Roentgenology

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The TV plays an important role in a number of pathologic states, and its abnormality can directly or indirectly influence morbidity and mortality in different cardiac disorders. However, the importance of the role of the TV has been overlooked primarily because TV malfunction may remain less symptomatic for a long time. Along with rapid development in imaging technology, improvement in postoperative management, and better understanding of the pathophysiologic mechanisms of TV dysfunction, more attention is being given to careful imaging analysis of this "forgotten valve."

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Magnetic resonance imaging in valvular heart disease: Clinical application and current role for patient management

Cited by 23 publications

References 90 publications

Magnetic Resonance and Computed Tomography Imaging of the Structural and Functional Changes of Pulmonary Arterial Hypertension

Magnetic Resonance and Computed Tomography Imaging of the Structural and Functional Changes of Pulmonary Arterial Hypertension

Role of Cardiac Magnetic Resonance Imaging in Valvular Heart Disease: Diagnosis, Assessment, and Management

Imaging Evaluation of Tricuspid Valve: Analysis of Morphology and Function With CT and MRI

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