Advantage of cine-MR imaging for the evaluation of valvular regurgitation

It is well known that the regurgitant blood flow of valvular disease shows a low intensity signal (LS) in cine-MR imaging (cMRI). To determine the significance of cMRI in evaluation of valvular regurgitation, 104 patients who had been assessed by cineangiography also underwent oblique cMRI for mitral regurgitation (MR) and aortic regurgitation (AR), and transverse cMRI for tricuspid regurgitation (TR). In evaluating the accuracy of diagnosis of valvular regurgitation on the basis of the presence of LS in the recipient chamber, sensitivity was found to be 93.5% for MR, 100% for AR and 85.7% for TR; specificity was 76.9% for MR and 100% for AR. The length and area of LS were planimetered in any view with the largest area, and its ratios to the length and area of the recipient chamber of view were calculated. Each index was significantly higher than the degree calculated by cineangiography. The best correlation with angiography was the ratio of the area of LS to the recipient chamber, and a semiquantitative classification by the index was coincident with angiographic severity in 38 of 43 (88.4%) patients undergoing MR, and in 28 of 30 (93.3%) patients undergoing AR. Thus, cMRI is a clinically useful noninvasive method in the identification and semiquantitative assessment of regurgitation severity.