Advanced cardiac MRI techniques for evaluation of left‐sided valvular heart disease

Blanken, Carmen P.S.; Farag, Emile S.; Boekholdt, S. Matthijs; Leiner, Tim; Kluin, Jolanda; Nederveen, Aart J.; Ooij, Pim van; Planken, R. Nils

doi:10.1002/jmri.26204

Cited by 38 publications

(23 citation statements)

References 111 publications

(121 reference statements)

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“…CMR and echocardiography are noninvasive imaging modalities that are of paramount importance in daily clinical practice for diagnosis, prognosis and treatment planning in patients with left-sided valvular heart disease (VHD). [1]…”

Section: Discussionmentioning

confidence: 99%

“…CMR is an established diagnostic modality for assessment of left-sided VHD and is progressively gaining ground in modern-day clinical practice. [1] CMR provides accurate information on functional and morphological valvular abnormalities, VHD severity and left ventricular function. Recent clinical guidelines recommend CMR as an alternative to inconclusive TTE examinations, caused by poor acoustic windows, for instance.…”

Section: Discussionmentioning

confidence: 99%

“…In some situations, CMR could help to better quantify a valve dysfunction, especially when the echocardiographic evaluation is difficult or inconclusive. [1]…”

Section: Introductionmentioning

confidence: 99%

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“where is the heart?” When cardiac magnetic resonance imaging helps if echocardiography is inconclusive

Caretta

Leo

Paiocchi

et al. 2019

J Cardiovasc Echography

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Cardiovascular magnetic resonance (CMR) is the gold standard technique to comprehensively assess cardiac structure and function. A 64-year-old male, planned for surgical coronary revascularization, underwent transthoracic and transesophageal echocardiography for a mitral regurgitation, with an eccentric jet of unclear mechanism; these examinations were inconclusive because of the lack of adequate visualization of the cardiac structures. A CMR was then performed to quantify mitral regurgitation and, additionally, it documented a giant hiatus hernia with gastric sliding into the thorax. In this case, CMR helped to better define the severity of a valvular disease and provided ancillary information from the extracardiac findings.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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“where is the heart?” When cardiac magnetic resonance imaging helps if echocardiography is inconclusive

Caretta

Leo

Paiocchi

et al. 2019

J Cardiovasc Echography

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“…Cardiovascular phase contrast magnetic resonance imaging (PC‐MRI) is a well‐validated method to quantify pulsatile blood flow in the human aorta . Time‐resolved three‐dimensional PC MRI scans (4D flow MRI) are used to observe velocity or blood flow patterns and identify possible abnormalities such as flow jets or regurgitation . Moreover, advanced hemodynamic biomarkers can be derived, such as pulse wave velocity and wall‐shear stress (WSS).…”

Section: Introductionmentioning

confidence: 99%

“…1 Time-resolved three-dimensional PC MRI scans (4D flow MRI) are used to observe velocity or blood flow patterns and identify possible abnormalities such as flow jets or regurgitation. 2 Moreover, advanced hemodynamic biomarkers can be derived, such as pulse wave velocity and wall-shear stress (WSS). These biomarkers have shown to be valuable tools for risk assessment in aortic aneurysms, aortic plaques and stroke.…”

Section: Introductionmentioning

confidence: 99%

Pseudo‐spiral sampling and compressed sensing reconstruction provides flexibility of temporal resolution in accelerated aortic 4D flow MRI: A comparison with k‐t principal component analysis

et al. 2020

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Introduction Time‐resolved three‐dimensional phase contrast MRI (4D flow) of aortic blood flow requires acceleration to reduce scan time. Two established techniques for highly accelerated 4D flow MRI are k‐t principal component analysis (k‐t PCA) and compressed sensing (CS), which employ either regular or random k‐space undersampling. The goal of this study was to gain insights into the quantitative differences between k‐t PCA‐ and CS‐derived aortic blood flow, especially for high temporal resolution CS 4D flow MRI. Methods The scan protocol consisted of both k‐t PCA and CS accelerated 4D flow MRI, as well as a 2D flow reference scan through the ascending aorta acquired in 15 subjects. 4D flow scans were accelerated with factor R = 8. For CS accelerated scans, we used a pseudo‐spiral Cartesian sampling scheme, which could additionally be reconstructed at higher temporal resolution, resulting in R = 13. 4D flow data were compared with the 2D flow scan in terms of flow, peak flow and stroke volume. A 3D peak systolic voxel‐wise velocity and wall shear stress (WSS) comparison between k‐t PCA and CS 4D flow was also performed. Results The mean difference in flow/peak flow/stroke volume between the 2D flow scan and the 4D flow CS with R = 8 and R = 13 was 4.2%/9.1%/3.0% and 5.3%/7.1%/1.9%, respectively, whereas for k‐t PCA with R = 8 the difference was 9.7%/25.8%/10.4%. In the voxel‐by‐voxel 4D flow comparison we found 13.6% and 3.5% lower velocity and WSS values of k‐t PCA compared with CS with R = 8, and 15.9% and 5.5% lower velocity and WSS values of k‐t PCA compared with CS with R = 13. Conclusion Pseudo‐spiral accelerated 4D flow acquisitions in combination with CS reconstruction provides a flexible choice of temporal resolution. We showed that our proposed strategy achieves better agreement in flow values with 2D reference scans compared with using k‐t PCA accelerated acquisitions.

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4D Flow Cardiac MR in Primary Mitral Regurgitation

Gorecka,

Cole,

Bissell

et al. 2024

Magnetic Resonance Imaging

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BackgroundFour‐dimensional‐flow cardiac MR (4DF‐MR) offers advantages in primary mitral regurgitation. The relationship between 4DF‐MR‐derived mitral regurgitant volume (MR‐Rvol) and the post‐operative left ventricular (LV) reverse remodeling has not yet been established.PurposeTo ascertain if the 4DF‐MR‐derived MR‐Rvol correlates with the LV reverse remodeling in primary mitral regurgitation.Study TypeProspective, single‐center, two arm, interventional vs. nonintervention observational study.PopulationForty‐four patients (male N = 30; median age 68 [59–75]) with at least moderate primary mitral regurgitation; either awaiting mitral valve surgery (repair [MVr], replacement [MVR]) or undergoing “watchful waiting” (WW).Field Strength/Sequence5 T/Balanced steady‐state free precession (bSSFP) sequence/Phase contrast imaging/Multishot echo‐planar imaging pulse sequence (five shots).AssessmentPatients underwent transthoracic echocardiography (TTE), phase‐contrast MR (PMRI), 4DF‐MR and 6‐minute walk test (6MWT) at baseline, and a follow‐up PMRI and 6MWT at 6 months. MR‐Rvol was quantified by PMRI, 4DF‐MR, and TTE by one observer. The pre‐operative MR‐Rvol was correlated with the post‐operative decrease in the LV end‐diastolic volume index (LVEDVi).Statistical TestsIncluded Student t‐test/Mann–Whitney test/Fisher's exact test, Bland–Altman plots, linear regression analysis and receiver operating characteristic curves. Statistical significance was defined as P < 0.05.ResultsWhile Bland–Altman plots demonstrated similar bias between all the modalities, the limits of agreement were narrower between 4DF‐MR and PMRI (bias 15; limits of agreement −36 mL to 65 mL), than between 4DF‐MR and TTE (bias −8; limits of agreement −106 mL to 90 mL) and PMRI and TTE (bias −23; limits of agreement −105 mL to 59 mL). Linear regression analysis demonstrated a significant association between the MR‐Rvol and the post‐operative decrease in the LVEDVi, when the MR‐Rvol was quantified by PMRI and 4DF‐MR, but not by TTE (P = 0.73). 4DF‐MR demonstrated the best diagnostic performance for reduction in the post‐operative LVEDVi with the largest area under the curve (4DF‐MR 0.83; vs. PMRI 0.78; and TTE 0.51; P = 0.89).Data ConclusionThis study demonstrates the potential clinical utility of 4DF‐MR in the assessment of primary mitral regurgitation.Evidence Level2Technical EfficacyStage 5

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Advanced cardiac MRI techniques for evaluation of left‐sided valvular heart disease

Abstract: 1 Technical Efficacy Stage: 1 J. Magn. Reson. Imaging 2018. J. MAGN. RESON. IMAGING 2018;48:318-329.

Cited by 38 publications

References 111 publications

“where is the heart?” When cardiac magnetic resonance imaging helps if echocardiography is inconclusive

“where is the heart?” When cardiac magnetic resonance imaging helps if echocardiography is inconclusive

Pseudo‐spiral sampling and compressed sensing reconstruction provides flexibility of temporal resolution in accelerated aortic 4D flow MRI: A comparison with k‐t principal component analysis

4D Flow Cardiac MR in Primary Mitral Regurgitation

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