Quantitating aortic regurgitation by cardiovascular magnetic resonance: significant variations due to slice location and breath holding
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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.
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).
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.
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.
• 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.
KeywordsMagnetic resonance imaging Phase contrast Aortic regurgitation Quantification Free breathing
The scientific guarantor of this publication is Jeffery H. Maki. The authors of this manuscript declare relationships with the following companies: none. This study has received funding by research grants from the Society for Cardiovascular Angiography and Interventions, General Electric, and the John L. Locke Jr. Charitable Trust. Dr. Christian H. Craig was supported by the Smart Futures Fellowship early career grant and the Washington-Queensland Trans-Pacific Fellowship Trust. Timothy M. Baran kindly provided statistical advice for this manuscript. Institutional review board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Some study subjects or cohorts have been previously reported (Circ Cardiovasc Imaging 6:48–57, 2003). Methodology: prospective, observational, performed at one institution.
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