Planimetry of the Orifice Area in Aortic Valve Stenosis Using Phase-Contrast Cardiac Magnetic Resonance Imaging
| Autor: | Tetsuya Sumiyoshi, Kaori Takada, Hajime Abe, Yuko Utanohara, Norihiko Takeda, Nobuo Iguchi, Haruhiko Machida, Yasuki Hen |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Aortic valve medicine.medical_specialty Phase contrast microscopy Magnetic Resonance Imaging Cine 030204 cardiovascular system & hematology Severity of Illness Index 030218 nuclear medicine & medical imaging law.invention 03 medical and health sciences 0302 clinical medicine law Cardiac magnetic resonance imaging Internal medicine medicine Humans cardiovascular diseases Aged Retrospective Studies Aged 80 and over medicine.diagnostic_test business.industry Calcinosis Reproducibility of Results Magnetic resonance imaging Aortic Valve Stenosis General Medicine Middle Aged medicine.disease Aortic orifice Stenosis medicine.anatomical_structure Orifice area Aortic Valve Aortic valve stenosis cardiovascular system Cardiology Female Cardiology and Cardiovascular Medicine business human activities Echocardiography Transesophageal Follow-Up Studies circulatory and respiratory physiology |
| Zdroj: | International Heart Journal. 59:77-80 |
| ISSN: | 1349-3299 1349-2365 |
| DOI: | 10.1536/ihj.16-542 |
| Popis: | Manual planimetry is a well-established method using transesophageal echocardiography (TEE) to assess the severity of aortic stenosis (AS). TEE, however, is a less than optimal approach in patients with calcified valves. Even when using cine-cardiac magnetic resonance (CMR), it is often difficult to evaluate the true border of the aortic orifice because of jet turbulence. With phase-contrast sequences of CMR, high flow signals at the aortic orifice can be clearly visualized, even in cases with severe calcification and jet turbulence. Therefore, the aims of the present study were to compare the utility of CMR using phase-contrast imaging with TEE and cine-CMR for the performance of planimetry of the aortic valve. The study cohort consisted of 30 consecutive patients with moderate or severe aortic valve stenosis documented by TEE who had undergone phase-contrast and cine-CMR for the evaluation of AS. Manual planimetry of the area of high flow signal was traced over the phase-contrast images at systolic peak, when the aortic valve is maximally opened. The results showed that the aortic valvular area (AVA) value derived from TEE correlated better with phase-contrast planimetry (r2 = 0.84, P < 0.05) than cine-mode planimetry (r2 = 0.57, P < 0.05). Bland-Altman plots indicated that the variation of measuring AVA was greater using the cine-mode method than the phase-contrast method. In conclusion, phase-contrast CMR offers a tool for evaluating the severity of aortic valve stenosis noninvasively. Phase-contrast CMR has the potential to become a routine clinical option as an alternative to TEE, at least in selected cases. |
| Databáze: | OpenAIRE |
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