Related Experiment Videos
Cine MR imaging in aortic stenosis
1David W. Devon Medical Imaging Center, Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia 19104.
Abstract:
The potential of cine magnetic resonance (MR) imaging for the assessment of aortic stenosis (AS) was investigated in 17 patients. The severity of AS was graded by continuous wave Doppler ultrasound as severe in 10 of 17 patients and as moderate in the remaining 7 patients. Cine MR demonstrated a flow disturbance proximal and/or distal to the aortic valve plane in all 17 patients. This flow disturbance was seen as a signal void with four typical features: (a) a high-velocity jet phenomenon distal to the valve plane during systole, closely related to the stenotic orifice (8 of 17); (b) a turbulent systolic signal void in continuity with the jet, which propagated for a variable extent into the aorta (17 of 17); (c) a signal void just proximal to the valve plane during systolic ejection, reflecting prestenotic acceleration of blood flow (5 of 17); and (d) a void at the valve plane due to valvular calcifications (14 of 17). The following features or a combination thereof appeared to correlate with more severe grades of AS as visualized on cine MR display: (a) identification of narrow high-velocity jet phenomenon; (b) extensive propagation of the turbulent signal void into the aorta; and (c) presence of a prestenotic acceleration effect. Assessment of the severity of AS with cine MR is still limited. However, cine MR can identify the presence of AS and several flow phenomena that correlate with more severe degrees of stenosis.
Insights
Cine magnetic resonance (MR) imaging shows aortic stenosis (AS) flow disturbances. This technique can identify AS presence and correlate flow phenomena with stenosis severity.
Area of Science:
- Cardiovascular Imaging
- Medical Physics
Background:
- Aortic stenosis (AS) is a significant valvular heart disease.
- Accurate assessment of AS severity is crucial for patient management.
- Continuous wave Doppler ultrasound is the current standard for AS assessment.
Purpose of the Study:
- To investigate the potential of cine magnetic resonance (MR) imaging for assessing aortic stenosis (AS).
- To identify specific flow disturbances visualized by cine MR that correlate with AS severity.
Main Methods:
- Seventeen patients with AS (10 severe, 7 moderate) were evaluated using cine MR imaging.
- AS severity was initially graded by continuous wave Doppler ultrasound.
- Cine MR imaging analyzed flow disturbances, signal voids, and their characteristics.
Main Results:
- Cine MR imaging detected flow disturbances in all 17 patients.
- Observed flow disturbances included high-velocity jets, turbulent systolic voids, prestenotic acceleration, and signal voids from calcifications.
- Narrow high-velocity jets, extensive turbulent void propagation, and prestenotic acceleration correlated with more severe AS.
Conclusions:
- Cine MR imaging can identify the presence of AS.
- Specific flow phenomena visualized by cine MR correlate with AS severity.
- While assessment of AS severity with cine MR is limited, it shows promise for identifying stenosis and related flow dynamics.