Abstract
Despite the possibility to address the pathologic status of cardiac valves either in terms of morphology or in terms of function, the role of CMR in valvular heart disease remains in a second level with respect to Echocardiography. On the technical point of view, this is mainly due to a reduced spatial resolution and in some images, such as T2w images, a reduced temporal resolution. However, this does not mean that in some cases the added value of CMR might be relevant and can help the clinician and the surgeon to take crucial decision. Besides morphology, and functional findings such as the quantitative evaluation of regurgitant fraction, the possibility to evaluate the concomitant biventricular volumes and function is becoming a recognized tool with clinical value. Finally, it is now evident that as a consequence of the valvular abnormality, the adaptive changes occurring at the level of the myocardium, such as myocardial fibrosis, are relevant and might have a role on the therapeutic decision-making.
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4.1 Electronic Supplementary Material
SSFP cine images in vertical long-axis plane. Evidence of reduced mobility of mitral leaflets. Diffuse hypertrophy of left-ventricle walls (AVI 1287 kb)
SSFP cine images in horizontal long-axis plane. Evidence of reduced mobility of mitral leaflets. Diffuse hypertrophy of left-ventricle walls (AVI 962 kb)
SSFP cine images in short axis of the aortic valve. Evidence of thickened valvular leaflets with reduced systolic opening. The planimetric measurement showed a residual 0.85 cm2 systolic opening (AVI 972 kb)
SSFP cine images in vertical long-axis plane. Evidence of mitral prolapse and mitral regurgitation (AVI 6243 kb)
SSFP cine images in horizontal long-axis plane. Evidence of mitral prolapse and mitral regurgitation (AVI 6243 kb)
SSFP cine images in horizontal long axis. Evidence of mitral and tricuspid regurgitation. Atrial enlargement (AVI 117614 kb)
SSFP cine images in short-axis view to image the Gore-Tex mitral annulus (AVI 117614 kb)
SSFP cine images in three-chamber view. Evidence of the turbulence due to the severe aortic valve regurgitation and the mitral valve regurgitation (AVI 79055 kb)
SSFP cine images in short-axis view of the heart. Evidence of a single papillary muscle (AVI 630 kb)
SSFP cine images in three-chamber view. Evidence of a single papillary muscle ruling the mitral leaflets (AVI 596 kb)
SSFP cine images in short-axis view of the aortic valve. Evidence of two Valsalva sinuses and bicuspid opening (AVI 609 kb)
SSFP cine image in horizontal long-axis view of the heart. Evidence of prolapse of the anterior leaflet of the mitral valve (AVI 8332 kb)
SSFP cine images in sagittal plane to assess the morphology of thoracic aorta which shows a normal course and normal diameters (AVI 6421 kb)
SSFP cine images in coronal plane. Evidence of gross aortic valve morphologic abnormalities and turbulence of flow during the systolic phase (AVI 1158 kb)
SSFP cine images in three-chamber view. Evidence of gross aortic valve morphologic abnormalities and turbulence of flow during the systolic phase (AVI 950 kb)
SSFP cine images in short axis of the aortic valve. Evidence of gross aortic valve morphologic abnormalities and reduction of the systolic opening (AVI 542 kb)
SSFP cine images of the heart. Horizontal long axis. Normal bi-ventricular global function (AVI 117614 kb)
SSFP cine images in coronal plane. Evidence of significant backward flow during the whole diastolic phase (AVI 117614 kb)
SSFP cine images thorough the aortic valvular plane. Evidence of thickened valvular leaflets. Presence of artifacts due to the turbulence of flow (AVI 117614 kb)
SSFP cine images in oblique view to evaluate the outflow tract of the left ventricle. Evidence of a linear thin structure 1 cm below the valvular plane. During the systolic phase evidence of turbulent flow originating at the level of the subvalvular stenosis (AVI 7265 kb)
SSFP cine images in oblique view to evaluate the outflow tract of the left ventricle. Slightly different plane with respect to Movie 4.20 but with a different number of reconstructed phase of the cardiac cycle: 60 instead of 30. Evidence of a linear thin structure 1 cm below the valvular plane. During the systolic phase evidence of turbulent flow originating at the level of the subvalvular stenosis (AVI 16529 kb)
SSFP cine images in oblique view. High-temporal-resolution sequence (100 frames/heartbeat). Presence of a discrete subaortic membrane, a thickened aortic valve, evidence of turbulent flow at the level of the aortic root and ascending Aorta, and evidence of aortic regurgitation (AVI 23369 kb)
SSFP cine images in short axis of the aortic valve. Evidence of “typical” bicuspid opening of the valvular leaflets (AVI 6294 kb)
SSFP cine images in three-chamber view. Evidence of turbulent flow during the systolic phase and regurgitant flow during the diastolic phase (AVI 9384 kb)
SSFP cine images in paraxial plane to evaluate course and dimension (“candy-cane” images) of aorta. Evidence of ascending Aorta enlargement (AVI 5823 kb)
SSFP cine images in short axis of the aortic valve showing the elliptical opening of the valve (AVI 5352 kb)
SSFP cine images in oblique view to assess the bicuspid morphology of the aortic valve. In the same plane there is also evidence of the isthmic coarctation (AVI 992 kb)
SSFP cine images in horizontal long-axis plane. Evidence of enlargement of the right chamber and namely of the right ventricle. During the systolic phase evidence of tricuspid regurgitation (AVI 1091 kb)
SSFP cine images in horizontal long-axis plane (more caudal than Movie 4.28). Evidence of enlargement of the right chamber and namely of the right ventricle. During the systolic phase evidence of tricuspid regurgitation (more evident than in Movie 4.28) (AVI 1111 kb)
SSFP cine images in vertical long axis of the right ventricle. During the systolic phase evidence of tricuspid regurgitation (AVI 1027 kb)
SSFP cine images in horizontal long axis of the heart. Evidence of displacement of the septal leaflets of the tricuspid valve. Right-ventricle enlargement with part of the right ventricle being atrialized. Presence of the atrial septal occluder. Evidence of systolic regurgitation at the level of the tricuspid valve (AVI 6496 kb)
SSFP cine images in horizontal long axis of the heart (more cranial with respect to Movie 4.31). Evidence of displacement of the septal leaflets of the tricuspid valve. Right-ventricle enlargement with part of the right ventricle being atrialized. Presence of the atrial septal occluder. Evidence of systolic regurgitation at the level of the tricuspid valve (AVI 6745 kb)
SSFP cine images in short axis of the heart. Evidence of marked enlargement of the right ventricle. Evidence of turbulent flow at the level of the tricuspid valve during the systolic phase (AVI 5763 kb)
SSFP cine images in parasagittal plane to assess the outflow tract of the right ventricle and the pulmonary trunk. Evidence of Pulmonary trunk enlargement and pulmonary regurgitation during the diastolic phase (AVI 892 kb)
Flow images of supravalvular ascending Aorta. Left panel: phase-contrast images. Right panel: magnitude images (presurgical images) (AVI 117614 kb)
SSFP cine images (sagittal plane) through the right outflow tract (presurgical images) (AVI 117614 kb)
Flow images (oblique plane) through the interatrial septum with evidence of the anatomical defect. Left panel: phase-contrast images. Right panel: magnitude images (AVI 78410 kb)
Flow images of Pulmonary valve. Left panel: phase contrast images. Right panel: magnitude images (presurgical images) (AVI 117614 kb)
SSFP cine images. Short axis of left ventricle (presurgical images) (AVI 117614 kb)
SSFP cine images. Oblique axis to identify the interatrial defect (presurgical images) (AVI 117614 kb)
SSFP cine images (sagittal plane) through the right outflow tract (postsurgical images) (AVI 117614 kb)
Flow images of pulmonary valve. Left panel: phase contrast images. Right panel: magnitude images (postsurgical images) (AVI 117614 kb)
SSFP cine images. Short axis of left ventricle (postsurgical images) (AVI 117614 kb)
SSFP cine images. Oblique axis to verify the interatrial defect closure (postsurgical images) (AVI 117614 kb)
SSFP cine images. Horizontal long axis (postsurgical images) (AVI 117614 kb)
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Rustamova, Y., Lombardi, M. (2020). Valvular Heart Diseases. In: Cardiac Magnetic Resonance Atlas. Springer, Cham. https://doi.org/10.1007/978-3-030-41830-4_4
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DOI: https://doi.org/10.1007/978-3-030-41830-4_4
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