Oblique cine MRI for the evaluation of aortic regurgitation: comparison with cineangiography

The results of oblique cine magnetic resonance imaging (MRI) through a long axis slice of the left ventricle in 40 patients was compared with cineangiography in order to determine the usefulness of cine MR imaging for the evaluation of aortic regurgitation (AR). A diastolic dark low-intensity flow signal extending from the aortic valve into the left ventricle was seen in all 30 patients with AR, and in none of the 10 patients without AR. The length and area of the low-intensity signal due to the regurgitant flow were planimetered, and the ratio to the length and area of the left ventricle was calculated. The best correlation with angiography was with the ratio of the area of the low-intensity signal (ALIS) to the area of the left ventricle (ALV); it correctly classified the degree of regurgitation in 28 of the 30 patients (93.3%). The ALIS/ALV ratio was under 25% in all 11 patients with angiographic mild AR, 26-50% in 10 of the 11 patients with moderate AR, and over 51% in 7 of the 8 patients with severe AR. Thus the results point to a high degree of correlation between long axis oblique cine MRI and cineangiography in the identification of AR and in providing a semiquantitative estimation of its severity.