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Untersuchungstechniken und Stellenwert der MRT bei der Diagnostik von Herzklappenerkrankungen

Imaging technique and current status of valvular heart disease using cardiac MRI

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Zusammenfassung

Die Untersuchung der Herzklappen in der MRT umfasst derzeit v. a. die Aorten- und Pulmonalisklappe. Pathologien der atrioventrikulären Klappen bilden demgegenüber nur selten die zentrale Fragestellung einer kardialen MRT-Untersuchung, da diese normalerweise einer echokardiographischen Untersuchung gut zugänglich sind. Die Stärke der MRT ist die hohe Zuverlässigkeit, mit der neben der Klappenmorphologie und -funktion die Funktionsparameter des jeweiligen Ventrikels und die Morphologie der nachgeschalteten Arterien bestimmt werden können. Dadurch kann die MRT die prinzipielle Schwäche in der Orts- und Zeitauflösung gegenüber der Echokardiographie teilweise kompensieren. Bei Patienten mit kongenitalen Herzvitien ist die MRT-basierte Klappendiagnostik fester Bestandteil des klinischen Managements. Das gilt besonders für die Evaluation der Pulmonalisklappe. Die Echokardiographie bleibt absehbar die Modalität der ersten Wahl für die Klappendiagnostik am Herzen.

Abstract

The main indications for cardiac magnetic resonance imaging (MRI) in the evaluation of valvular heart disease are pathologies of the aortic and pulmonary valve. For mitral and tricuspid valve pathologies MRI is not the first line modality as these are usually well visualized by echocardiography. The advantages of MRI in valvular heart disease are a high reliability in the evaluation of ventricular volumes and function as well as the assessment of the perivalvular arterial or atrial structures. This reliability and the limitless access to any imaging plane partially compensates for the lower temporal and spatial resolution in comparison to echocardiography. In patients with congenital heart disease, cardiac MRI is established as a valuable diagnostic tool in daily clinical management, especially for the evaluation of pulmonary valve defects. Nevertheless, echocardiography remains the first-line diagnostic imaging tool for the foreseeable future.

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Abbreviations

Ao:

Aorta

AK:

Aortenklappe

CMR:

Kardiale Magnetresonanztomographie

CT:

Computertomographie

Echo:

Echokardiographie

FOV:

„Field of view“

KÖF:

Klappenöffnungsfläche

LA:

Linker Vorhof

LV:

Linker Ventrikel

LVOT:

Linksventrikulärer Ausflusstrakt

MRT:

Magnetresonanztomographie

Pa/PA:

Truncus pulmonalis

RA:

Rechter Vorhof

RV:

Rechter Ventrikel

RVOT:

Rechtsventrikulärer Ausflusstrakt

T:

Tesla

TEE:

Transösophageale Echokardiographie

TTE:

Transthorakale Echokardiographie

US:

Ultraschall

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Einhaltung ethischer Richtlinien

Interessenkonflikt. J. Lotz und J.M. Sohns geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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  1. Institut für Diagnostische und Interventionelle Radiologie, Universitätsmedizin Göttingen, Georg-August-Universität, UBFT 2.C2.515, Robert-Koch-Str. 40, 37075, Göttingen, Deutschland

    J. Lotz & J.M. Sohns MD

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  1. J. Lotz
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  2. J.M. Sohns MD
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Correspondence to J. Lotz.

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Lotz, J., Sohns, J. Untersuchungstechniken und Stellenwert der MRT bei der Diagnostik von Herzklappenerkrankungen. Radiologe 53, 872–879 (2013). https://doi.org/10.1007/s00117-012-2468-z

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