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British Heart Journal logoLink to British Heart Journal
. 1986 Nov;56(5):455–462. doi: 10.1136/hrt.56.5.455

Magnetic resonance assessment of aortic and mitral regurgitation.

S R Underwood, R H Klipstein, D N Firmin, K M Fox, P A Poole-Wilson, R S Rees, D B Longmore
PMCID: PMC1236893  PMID: 3790381

Abstract

Magnetic resonance imaging provides an accurate method for the measurement of left and right ventricular volume. The ratio of left ventricular stroke volume to right ventricular stroke volume was calculated from contiguous transverse magnetic resonance images and was used to measure the severity of regurgitation in 18 patients with aortic regurgitation and 10 with mitral regurgitation. Cardiac anatomy was well demonstrated, allowing an assessment of relative chamber volumes and associated abnormalities, although valve abnormality was not well seen. There was a weak correlation between magnetic resonance measurements of left ventricular end diastolic volume and stroke volume ratio. The stroke volume ratio differed significantly in four groups with increasing angiographic severity of regurgitation, and all but the group with trivial regurgitation differed significantly from normal. There was good correlation between magnetic resonance and radionuclide measurements of left ventricular ejection fraction and stroke volume ratio, although the stroke volume ratio was consistently overestimated by radionuclide ventriculography. Correlation was less good for the right ventricular ejection fraction, which was underestimated by radionuclide ventriculography. It is concluded that magnetic resonance imaging provides valuable information in patients with valvar regurgitation, and serves as a suitable standard by which to judge conventional techniques.

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Selected References

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  1. Alderson P. O. Radionuclide quantification of valvular regurgitation. J Nucl Med. 1982 Sep;23(9):851–855. [PubMed] [Google Scholar]
  2. Bailes D. R., Gilderdale D. J., Bydder G. M., Collins A. G., Firmin D. N. Respiratory ordered phase encoding (ROPE): a method for reducing respiratory motion artefacts in MR imaging. J Comput Assist Tomogr. 1985 Jul-Aug;9(4):835–838. [PubMed] [Google Scholar]
  3. Berthout P., Cardot J. C., Baud M., Faivre R., Verdenet J., Bidet A. C., Bassand J. P., Bidet R., Maurat J. P. Factors influencing the quantification of valvular regurgitation by gated equilibrium radionuclide angiography. Eur J Nucl Med. 1984;9(3):112–114. doi: 10.1007/BF00253511. [DOI] [PubMed] [Google Scholar]
  4. Come P. C. The optimal Doppler examination: pulsed, continuous wave or both? J Am Coll Cardiol. 1986 Apr;7(4):886–888. doi: 10.1016/s0735-1097(86)80352-7. [DOI] [PubMed] [Google Scholar]
  5. Goldman M. E. Real-time two-dimensional Doppler flow imaging: a word of caution. J Am Coll Cardiol. 1986 Jan;7(1):89–90. doi: 10.1016/s0735-1097(86)80264-9. [DOI] [PubMed] [Google Scholar]
  6. Higgins C. B., Byrd B. F., 2nd, McNamara M. T., Lanzer P., Lipton M. J., Botvinick E., Schiller N. B., Crooks L. E., Kaufman L. Magnetic resonance imaging of the heart: a review of the experience in 172 subjects. Radiology. 1985 Jun;155(3):671–679. doi: 10.1148/radiology.155.3.3159039. [DOI] [PubMed] [Google Scholar]
  7. Higgins C. B., Kaufman L., Crooks L. E. Magnetic resonance imaging of the cardiovascular system. Am Heart J. 1985 Jan;109(1):136–152. doi: 10.1016/0002-8703(85)90426-0. [DOI] [PubMed] [Google Scholar]
  8. Hunt D., Baxley W. A., Kennedy J. W., Judge T. P., Williams J. E., Dodge H. T. Quantitative evaluation of cineaortography in the assessment of aortic regurgitation. Am J Cardiol. 1973 Jun;31(6):696–700. doi: 10.1016/0002-9149(73)90002-7. [DOI] [PubMed] [Google Scholar]
  9. Hurwitz R. A., Treves S., Freed M., Girod D. A., Caldwell R. L. Quantitation of aortic and mitral regurgitation in the pediatric population: evaluation by radionuclide angiocardiography. Am J Cardiol. 1983 Jan 15;51(2):252–255. doi: 10.1016/s0002-9149(83)80044-7. [DOI] [PubMed] [Google Scholar]
  10. Kirch D. L., Metz C. E., Steele P. P. Quantitation of valvular insufficiency by computerized radionuclide angiography. Am J Cardiol. 1974 Nov;34(6):711–721. doi: 10.1016/0002-9149(74)90162-3. [DOI] [PubMed] [Google Scholar]
  11. Longmore D. B., Klipstein R. H., Underwood S. R., Firmin D. N., Hounsfield G. N., Watanabe M., Bland C., Fox K., Poole-Wilson P. A., Rees R. S. Dimensional accuracy of magnetic resonance in studies of the heart. Lancet. 1985 Jun 15;1(8442):1360–1362. doi: 10.1016/s0140-6736(85)91786-6. [DOI] [PubMed] [Google Scholar]
  12. Mackenzie J. D., Haites N. E., Rawles J. M. Method of assessing the reproducibility of blood flow measurement: factors influencing the performance of thermodilution cardiac output computers. Br Heart J. 1986 Jan;55(1):14–24. doi: 10.1136/hrt.55.1.14. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Masuyama T., Kodama K., Kitabatake A., Nanto S., Sato H., Uematsu M., Inoue M., Kamada T. Noninvasive evaluation of aortic regurgitation by continuous-wave Doppler echocardiography. Circulation. 1986 Mar;73(3):460–466. doi: 10.1161/01.cir.73.3.460. [DOI] [PubMed] [Google Scholar]
  14. Mennel R. G., Joyner C. R., Jr, Thompson P. D., Pyle R. R., Macvaugh H., 3rd The preoperative and operative assessment of aortic regurgitation. Cineaortography vs. electromagnetic flowmeter. Am J Cardiol. 1972 Mar;29(3):360–366. doi: 10.1016/0002-9149(72)90531-0. [DOI] [PubMed] [Google Scholar]
  15. Miyatake K., Izumi S., Okamoto M., Kinoshita N., Asonuma H., Nakagawa H., Yamamoto K., Takamiya M., Sakakibara H., Nimura Y. Semiquantitative grading of severity of mitral regurgitation by real-time two-dimensional Doppler flow imaging technique. J Am Coll Cardiol. 1986 Jan;7(1):82–88. doi: 10.1016/s0735-1097(86)80263-7. [DOI] [PubMed] [Google Scholar]
  16. Miyatake K., Izumi S., Okamoto M., Kinoshita N., Asonuma H., Nakagawa H., Yamamoto K., Takamiya M., Sakakibara H., Nimura Y. Semiquantitative grading of severity of mitral regurgitation by real-time two-dimensional Doppler flow imaging technique. J Am Coll Cardiol. 1986 Jan;7(1):82–88. doi: 10.1016/s0735-1097(86)80263-7. [DOI] [PubMed] [Google Scholar]
  17. Nayler G. L., Firmin D. N., Longmore D. B. Blood flow imaging by cine magnetic resonance. J Comput Assist Tomogr. 1986 Sep-Oct;10(5):715–722. doi: 10.1097/00004728-198609000-00001. [DOI] [PubMed] [Google Scholar]
  18. Nicod P., Corbett J. R., Firth B. G., Dehmer G. J., Izquierdo C., Markham R. V., Jr, Hillis L. D., Willerson J. T., Lewis S. E. Radionuclide techniques for valvular regurgitant index: comparison in patients with normal and depressed ventricular function. J Nucl Med. 1982 Sep;23(9):763–769. [PubMed] [Google Scholar]
  19. Omoto R., Yokote Y., Takamoto S., Kyo S., Ueda K., Asano H., Namekawa K., Kasai C., Kondo Y., Koyano A. The development of real-time two-dimensional Doppler echocardiography and its clinical significance in acquired valvular diseases. With special reference to the evaluation of valvular regurgitation. Jpn Heart J. 1984 May;25(3):325–340. doi: 10.1536/ihj.25.325. [DOI] [PubMed] [Google Scholar]
  20. Parrish M. D., Graham T. P., Jr, Born M. L., Jones J. P., Boucek R. J., Jr, Artman M., Partain C. L. Radionuclide stroke count ratios for assessment of right and left ventricular volume overload in children. Am J Cardiol. 1983 Jan 15;51(2):261–264. doi: 10.1016/s0002-9149(83)80046-0. [DOI] [PubMed] [Google Scholar]
  21. Pavel D. G., Zimmer M., Patterson V. N. In vivo labeling of red blood cells with 99mTc: a new approach to blood pool visualization. J Nucl Med. 1977 Mar;18(3):305–308. [PubMed] [Google Scholar]
  22. Pons-Llado G., Carreras-Costa F., Ballester-Rodes M., Auge-Sampera J. M., Crexells-Figueras C., Oriol-Palou A. Pulsed Doppler patterns of left atrial flow in mitral regurgitation. Am J Cardiol. 1986 Apr 1;57(10):806–810. doi: 10.1016/0002-9149(86)90618-1. [DOI] [PubMed] [Google Scholar]
  23. REES R. S., JEFFERSON K. E., HARRIS A. M. CINE-ANGIOCARDIOGRAPHY OF THE MITRAL VALVE. Br Heart J. 1965 Jul;27:498–504. doi: 10.1136/hrt.27.4.498. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Rigo P., Alderson P. O., Robertson R. M., Becker L. C., Wagner H. N., Jr Measurement of aortic and mitral regurgitation by gated cardiac blood pool scans. Circulation. 1979 Aug;60(2):306–312. doi: 10.1161/01.cir.60.2.306. [DOI] [PubMed] [Google Scholar]
  25. Rzedzian R., Chapman B., Mansfield P., Coupland R. E., Doyle M., Chrispin A., Guilfoyle D., Small P. Real-time nuclear magnetic resonance clinical imaging in paediatrics. Lancet. 1983 Dec 3;2(8362):1281–1282. doi: 10.1016/s0140-6736(83)91153-4. [DOI] [PubMed] [Google Scholar]
  26. STEINER R. E., JACOBSON G., DINSMORE R., PARIZEL G. Mitral regurgitation. Clin Radiol. 1963 Apr;14:113–125. doi: 10.1016/s0009-9260(63)80068-9. [DOI] [PubMed] [Google Scholar]
  27. Schultz C. L., Alfidi R. J., Nelson A. D., Kopiwoda S. Y., Clampitt M. E. The effect of motion on two-dimensional Fourier transformation magnetic resonance images. Radiology. 1984 Jul;152(1):117–121. doi: 10.1148/radiology.152.1.6729101. [DOI] [PubMed] [Google Scholar]
  28. Soulen R. L., Budinger T. F., Higgins C. B. Magnetic resonance imaging of prosthetic heart valves. Radiology. 1985 Mar;154(3):705–707. doi: 10.1148/radiology.154.3.3969474. [DOI] [PubMed] [Google Scholar]
  29. Steiner R. E., Bydder G. M., Selwyn A., Deanfield J., Longmore D. B., Klipsten R. H., Firmin D. Nuclear magnetic resonance imaging of the heart. Current status and future prospects. Br Heart J. 1983 Sep;50(3):202–208. doi: 10.1136/hrt.50.3.202. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Suzuki Y., Kambara H., Kadota K., Tamaki S., Yamazato A., Nohara R., Osakada G., Kawai C. Detection and evaluation of tricuspid regurgitation using a real-time, two-dimensional, color-coded, Doppler flow imaging system: comparison with contrast two-dimensional echocardiography and right ventriculography. Am J Cardiol. 1986 Apr 1;57(10):811–815. doi: 10.1016/0002-9149(86)90619-3. [DOI] [PubMed] [Google Scholar]
  31. Wilde P., Pitcher D. Pulsed Doppler echocardiography in cardiac diagnosis. J R Coll Physicians Lond. 1986 Jan;20(1):25–31. [PMC free article] [PubMed] [Google Scholar]
  32. Zhang Y., Nitter-Hauge S., Ihlen H., Rootwelt K., Myhre E. Measurement of aortic regurgitation by Doppler echocardiography. Br Heart J. 1986 Jan;55(1):32–38. doi: 10.1136/hrt.55.1.32. [DOI] [PMC free article] [PubMed] [Google Scholar]
  33. von Schulthess G. K., Fisher M., Crooks L. E., Higgins C. B. Gated MR imaging of the heart: intracardiac signals in patients and healthy subjects. Radiology. 1985 Jul;156(1):125–132. doi: 10.1148/radiology.156.1.4001398. [DOI] [PubMed] [Google Scholar]

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