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

Abstract

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.

Cardiovascular magnetic resonance and transesophageal echocardiography in patients with prosthetic valve paravalvular leaks: towards an accurate quantification and stratification

“…The complex anatomy of leak channels preclude the use of the same echocardiography quantification as in native valve regurgitations. Besides, only a moderate agreement between echocardiography and CMR in those parameters using proximal isovelocity surface area (PISA) [ 11 ] was found. Finally, the quality of images (prosthesis) obtained in particular patient affects the measures of severity of PVL, especially in echocardiography.…”

“…CMR is considered the gold-standard for these purposes. Although CMR has been validated in the quantitative assessment of some native valve defects [ 10 , 11 ], the evidence supporting the role of CMR in patients with prosthetic valve PVL is scarce and limited to patients with transcatheter aortic valve implantation (TAVI) [ 12 , 13 ].…”

Anatomy of Mitral Valve Complex as Revealed by Non-Invasive Imaging: Pathological, Surgical and Interventional Implications

“…Though in recent years CMR and CT have been increasingly used for evaluating MV apparatus, especially in the pre-operative or pre-interventional setting [ 19 , 21 ], there is no doubt that 2D/3D TEEs are probably the best modalities for visualizing mitral leaflets. Remarkably, once acquired, 3D volumetric data set can be rotated and angulated, allowing visualization of leaflets in a countless number of perspectives.…”

Imaging in the investigation and management of Staphylococcus aureus bacteraemia: a role for advanced imaging techniques

“…In mice S. aureus-induced IE can be detected using MRI technology [20]. A review of the benefit of cardiac MRI found an increasing role in the diagnosis of valvular lesions, though vegetations can be easily missed due to the fine imaging slices used in cine [21]. In a small singlecentre study in Turkey cardiac MRI was requested on 16 patients with presumed IE to obtain additional information, particularly in six patients who had been unable to complete a TOE [22].…”