Does heart motion adapted cine phase-contrast flow measurement improve the quantification of regurgitant volume compared to spatially fixed slice imaging in patients with aortic regurgitation?
Heart motion adapted cine phase-contrast MRI corrects for through-plane motion, significantly increasing the measured regurgitant volume in patients with aortic regurgitation.
A method for magnetic resonance cine velocity mapping through heart valves with adaptation of both slice offset and angulation according to the motion of the valvular plane of the heart is presented.By means of a subtractive labeling technique, basal myocardial markers are obtained and automatically extracted for quantification of heart motion at the valvular level.The captured excursion of the basal plane is used to calculate the slice offset and angulation of each required time frame for cine velocity mapping.Through-plane velocity offsets are corrected by subtracting velocities introduced by basal plane motion from the measured velocities.For evaluation of the method, flow measurements downstream from the aortic valve were performed both with and without slice adaptation in 11 healthy volunteers and in four patients with aortic regurgitation.Maximum through-plane motion at the aortic root level as calculated from the labeled markers averaged 8.9 mm in the volunteers and 6.5 mm in the patients.The left coronary root was visible in 2-4 (mean: 2.2) time frames during early diastole when imaging with a spatially fixed slice.Time frames obtained with slice adaptation did not contain the coronary roots.Motion correction increased the apparent regurgitant volume by 5.7 ؎ 0.4 ml for patients with clinical aortic regurgitation, for an increase of approximately 50%.The proposed method provides flow measurements with correction for through-plane motion perpendicular to the aortic root between the valvular annulus and the coronary ostia throughout the cardiac cycle.
Kozerke et al. (1999) studied this question.