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Updated: Jun 16, 2025
In vitro Assessment of Aortic Regurgitation Using Four-Dimensional Flow Magnetic Resonance Imaging
Published on: February 25, 2022
Tricuspid Regurgitation Assessment Using Cardiac Magnetic Resonance Velocity-Encoded 4-Dimensional Flow
Ahmed S Negm1, Agata Sularz2, Abdullah Al-Abcha2
1Department of Radiology, Cardiovascular Imaging Division, Mayo Clinic, Rochester, Minnesota, USA.
Background:
Tricuspid regurgitation (TR) is a common valvular heart disease associated with right ventricular dysfunction and an increased risk of hospitalization because of heart failure. Accurate assessment of TR severity and right ventricular function is crucial for guiding management.
Case Summary:
We present 3 cases of TR evaluated with transthoracic echocardiography (TTE) cardiac magnetic resonance (CMR) with integrated 4-dimensional (4D) flow analysis. Case 1 demonstrated torrential TR on CMR, underestimated by TTE. Case 2 showed concordant findings across modalities. Case 3 revealed a discrepancy, with CMR suggesting mild-to-moderate TR and TTE indicated severe TR. Management decisions were guided by clinical status and multimodal imaging.
Discussion:
This series highlights the limitations of TTE in TR assessment and the utility of CMR with integrated 4D flow analysis for accurate TR quantification.
Take-Home Message:
Integration of CMR with 4D flow analysis into the multimodal evaluation of TR provides valuable diagnostic information when TTE findings are discordant with clinical status or inadequate because of imaging constraints.
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