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Valve and great vessel stenosis: assessment with MR jet velocity mapping

P J Kilner1, D N Firmin, R S Rees

  • 1Magnetic Resonance Unit, National Heart Hospital, London, England.

Radiology
|January 1, 1991
PubMed

Insights

This study optimized magnetic resonance (MR) imaging for measuring poststenotic jet velocities by reducing echo time. The new method accurately quanties high velocities, offering a valuable noninvasive tool for evaluating stenoses.

Area of Science:

  • Cardiovascular Imaging
  • Medical Physics
  • Fluid Dynamics

Background:

  • Accurate measurement of poststenotic jet velocities is crucial for diagnosing and managing various cardiovascular conditions.
  • Traditional magnetic resonance (MR) imaging techniques can suffer from signal loss in turbulent flow, limiting velocity quantification.
  • Optimizing MR imaging parameters is essential for improving the diagnostic accuracy of flow assessment.

Purpose of the Study:

  • To reduce echo time (TE) in the field even-echo rephasing (FEER) velocity mapping sequence for improved MR imaging of poststenotic jet velocities.
  • To minimize MR signal loss caused by turbulent fluid flow.
  • To validate the accuracy and clinical utility of the optimized MR imaging sequence.

Main Methods:

  • Reduced the echo time (TE) of the FEER velocity mapping sequence from 14.0 to 3.6 msec.
  • Utilized in vitro rotating disk and stenotic flow phantoms for validation.
  • Performed peak jet velocity measurements in 36 patients with various stenotic conditions using MR imaging.

Main Results:

  • The 3.6-msec TE sequence accurately measured jet velocities up to 6.0 m/sec in vitro (r = .996).
  • MR imaging measurements showed good agreement with Doppler ultrasound (US) in 18 patients (standard deviation = 0.2 m/sec).
  • The optimized MR sequence successfully quantified velocities in patients with native heart valve stenosis, conduits, Fontan connections, and aortic coarctation.

Conclusions:

  • Fast-echo MR imaging velocity mapping is a significant advancement for noninvasively locating and evaluating stenoses.
  • This technique is particularly valuable for assessing stenotic sites that are difficult to access with ultrasound.
  • Careful attention to potential errors, including malalignment, signal loss, phase wrap, and partial-volume effects, is necessary for accurate interpretation.

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