Magnetic resonance velocity mapping: clinical application of a new technique

Magnetic resonance velocity mapping is a new technique which provides a display of velocity within the cardiovascular system at any point of the cardiac cycle. A short field echo sequence with even echo rephasing is used to obtain a signal from rapidly moving blood and a cine display is provided by rapid repetition of the sequence. The amplitude image shows the anatomy, with blood giving a high signal and areas of turbulent flow no signal. The phase image is a map of velocities at each point in the image plane. Thirteen cases are described in which the technique either provided a diagnosis or helped in functional assessment. Flow through atrial and ventricular septal defects was seen, although turbulent flow distal to the ventricular shunts led to some loss of quantitative information. In three patients with valve disease jets of abnormal flow were seen because of signal loss and it is suggested that the size of the area of turbulence may be used to quantify the severity of regurgitation. Velocities were measured in four coronary artery bypass grafts in two patients, and low velocity was seen in a graft with distal disease that supplied the infarcted territory. Velocity was reduced distal to an aortic coarctation and it was increased at the site of narrowing caused by thrombosis in a deep vein. The speed and direction of flow in the central vessels in a patient with complex congenital heart disease helped to establish the anatomy. The technique provides useful information in a wide range of disorders of the cardiovascular system, and in some cases may avoid the need for invasive investigation.