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Calculations of cardiovascular shunts and regurgitation using magnetic resonance ventricular volume and aortic and pulmonary flow measurements

  • Magnetic Resonance
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Abstract

Background: Cardiovascular magnetic resonance measurements of the volumes of the right and left ventricle and of the flows in the ascending aorta and main pulmonary artery contribute to the assessment of patients with valvular regurgitation or intracardiac or extracardiac shunts. Ventricular volumes are measured by planimetry and summation of end-diastolic and end-systolic areas measured in a stack of ventricular short-axis cines. The volumes of blood flowing through planes transecting the great arteries are measured using phase contrast velocity mapping. The two approaches are essentially different and can be used either for mutual validation, or separately or in combination to quantify regurgitation and/or shunting. In the presence of shunts, the relations between the stroke volumes and arterial flows of each side of the heart vary depending on the level of shunting (for example, atrial, ventricular or ductal). Conclusion: This article aims to explain and illustrate the technical and theoretical basis for calculations using volumetric and flow measurements, providing formulae and diagrams to facilitate the interpretation of results.

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Abbreviations

CMR:

cardiovascular magnetic resonance

LV:

left ventricle

RV:

right ventricle

SV:

stroke volume

V:

volume

EDV:

end diastolic volume

ESV:

end systolic volume

Ao:

ascending aorta

MPA:

main pulmonary artery

R-R interval:

interval between two successive R peaks of the electrocardiogram

RA:

right atrium

QAo :

ascending aortic flow volume (per beat)

QMPA :

pulmonary flow volume (per beat)

QP :

pulmonary flow volume (per beat)

QS :

systemic flow volume (per beat)

VENC:

velocity encoding range

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Authors and Affiliations

  1. Department Radiology–MRI (-1K12), Ghent University Hospital, De Pintelaan 185, B-9000, Gent, Belgium

    Daniel G. H. Devos

  2. Department of Cardiac MRI, Royal Brompton Hospital, Sydney St, London, SW3 6NP, UK

    Philip J. Kilner

Authors
  1. Daniel G. H. Devos
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  2. Philip J. Kilner
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Correspondence to Daniel G. H. Devos.

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Devos, D.G.H., Kilner, P.J. Calculations of cardiovascular shunts and regurgitation using magnetic resonance ventricular volume and aortic and pulmonary flow measurements. Eur Radiol 20, 410–421 (2010). https://doi.org/10.1007/s00330-009-1568-2

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  • DOI: https://doi.org/10.1007/s00330-009-1568-2

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