Evaluation of aortic regurgitation by using PC MRI: A comparison of the accuracies at different image plane locations

Kim, Byeong-Gull; Kim, Kyung-Soo; Kim, Soon-Bae; Chung, Woon-Kwan; Cho, Jae-Hwan; Park, Yongsoon

doi:10.3938/jkps.61.1884

Cited by 4 publications

(4 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, the optimal location to most accurately measure AR is controversial19 20 because RF values vary depending on the plane that is used. Likewise, the stroke volume is also controversial.…”

Section: Discussionmentioning

confidence: 99%

“…There is some disagreement with regard to the optimal imaging plane to assess AR. Some authors propose placing the plane at the sinotubular junction or the proximal ascending aorta,19 while other authors advocate placement at the middle ascending aorta15 or below the aortic valve 20. At our institution, the slices are placed at the valve or the sinotubular junction, depending on the anatomical characteristics of the patient.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Clinical use of 4D flow MRI for quantification of aortic regurgitation

et al. 2020

View full text Add to dashboard Cite

ObjectiveThe main objective of the present study was to compare the use of four-dimensional (4D) flow MRI with the habitual sequence (two-dimensional phase-contrast (2DPC) MRI) for the assessment of aortic regurgitation (AR) in the clinical routine.MethodsThis was a retrospective, observational cohort study of patients with varying grades of AR. For the purposes of the present study, we selected all the cases with a regurgitant fraction (RF)>5% as determined by 2DPC MRI (n=34). In all cases, both sequences (2DPC and 4D flow MRI) were acquired in a single session to ensure comparability. We compared the results of the two techniques by evaluating forward flow, regurgitant flow and regurgitation fraction. Then, the patients were divided into subgroups to determine if these factors had any influence on the measurements: aortic diameter (≤ vs >38 mm), valve anatomy (tricuspid vs bicuspid/quadricuspid), stenosis (gradient ≥15 vs <15) and region of interest location (aortic valve vs sinotubular junction).ResultsNo statistically significant differences were observed between the two techniques with Pearson’s correlation coefficients (r) of forward flow (r=0.826/p value<0001), regurgitant flow (r=0.866/p value<0001) and RF (r=0.761/p value<0001).ConclusionsThe findings of this study confirm the value of 4D flow MRI for grading AR in clinical practice with an excellent correlation with the standard technique (2DPC MRI).

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Clinical use of 4D flow MRI for quantification of aortic regurgitation

et al. 2020

View full text Add to dashboard Cite

show abstract

“…There is no final recommendation regarding the optimal imaging plane for 2DPC aortic flow measurements with some authors preferring measurements near the aortic valve [6,7] and some in the ascending aorta [8][9][10][11]. Correspondingly, the optimal level for AR measurements in 4D flow CMR still needs to be defined.…”

Section: Introductionmentioning

confidence: 99%

Quantitative evaluation of aortic valve regurgitation in 4D flow cardiac magnetic resonance: at which level should we measure?

Polacin

Geiger²,

Burkhardt³

et al. 2022

BMC Med Imaging

View full text Add to dashboard Cite

Purpose To find the best level to measure aortic flow for quantification of aortic regurgitation (AR) in 4D flow CMR. Methods In 27 congenital heart disease patients with AR (67% male, 31 ± 16 years) two blinded observers measured antegrade, retrograde, net aortic flow volumes and regurgitant fractions at 6 levels in 4D flow: (1) below the aortic valve (AV), (2) at the AV, (3) at the aortic sinus, (4) at the sinotubular junction, (5) at the level of the pulmonary arteries (PA) and (6) below the brachiocephalic trunk. 2D phase contrast (2DPC) sequences were acquired at the level of PA. All patients received prior transthoracic echocardiography (TTE) with AR severity grading according to a recommended multiparametric approach. Results After assigning 2DPC measurements into AR grading, agreement between TTE AR grading and 2DPC was good (κ = 0.88). In 4D flow, antegrade flow was similar between the six levels (p = 0.87). Net flow was higher at level 1–2 than at levels 3–6 (p < 0.05). Retrograde flow and regurgitant fraction at level 1–2 were lower compared to levels 3–6 (p < 0.05). Reproducibility (inter-reader agreement: ICC 0.993, 95% CI 0.986–0.99; intra-reader agreement: ICC 0.982, 95%CI 0.943–0.994) as well as measurement agreement between 4D flow and 2DPC (ICC 0.994; 95%CI 0.989 – 0.998) was best at the level of PA. Conclusion For estimating severity of AR in 4D flow, best reproducibility along with best agreement with 2DPC measurements can be expected at the level of PA. Measurements at AV or below AV might underestimate AR.

show abstract

“…The motion of the valve according to the time can be easily tracked and compensated when measuring the regurgitant flow volume 8 , 9 . Also, an arbitrary plane perpendicular to the regurgitant jet can be retrospectively positioned, which increases the accuracy of the measurement 10 3. Prolapse: Fix the two commissures of the valve at a hole with a low post height.…”

Section: Introductionmentioning

confidence: 99%

<em>In vitro</em> Assessment of Aortic Regurgitation Using Four-Dimensional Flow Magnetic Resonance Imaging

Kim

Huh

2022

JoVE

View full text Add to dashboard Cite

Aortic regurgitation (AR) refers to backward blood flow from the aorta into the left ventricle (LV) during ventricular diastole. The regurgitant jet arising from the complex shape is characterized by the three-dimensional flow and high-velocity gradient, sometimes limiting an accurate measurement of the regurgitant volume using 2D echocardiography. Recently developed four-dimensional flow magnetic resonance imaging (4D flow MRI) enables three-dimensional volumetric flow measurements, which can be used to accurately quantify the amount of the regurgitation. This study focuses on (i) magnetic resonance compatible AR model fabrication (dilatation, perforation, and prolapse) and (ii) systematic analysis of the performance of 4D flow MRI in AR quantification. The results indicated that the formation of the forward and backward jets over time was highly dependent on the types of AR origin. The amount of regurgitation volume bias for the model types were -7.04%, -33.21%, 6.75%, and 37.04% compared to the ground truth (48 mL) volume measured from the pump stroke volume. The largest error of the regurgitation fraction was around 12%. These results indicate that careful selection of imaging parameters is required when absolute regurgitation volume is important. The suggested in vitro flow phantom can easily be modified to simulate other valvular diseases such as aortic stenosis or bicuspid aortic valve (BAV) and can be used as a standard platform to test different MRI sequences in the future.

show abstract

Evaluation of aortic regurgitation by using PC MRI: A comparison of the accuracies at different image plane locations

Cited by 4 publications

References 13 publications

Clinical use of 4D flow MRI for quantification of aortic regurgitation

Clinical use of 4D flow MRI for quantification of aortic regurgitation

Quantitative evaluation of aortic valve regurgitation in 4D flow cardiac magnetic resonance: at which level should we measure?

<em>In vitro</em> Assessment of Aortic Regurgitation Using Four-Dimensional Flow Magnetic Resonance Imaging

Contact Info

Product

Resources

About