Flow Assessment Through Four Heart Valves Simultaneously Using 3-Dimensional 3-Directional Velocity-Encoded Magnetic Resonance Imaging With Retrospective Valve Tracking in Healthy Volunteers and Patients With Valvular Regurgitation
OBJECTIVES:To validate 3-dimensional (3D) 3-directional velocity-encoded (VE) magnetic resonance imaging (MRI) for flow assessment through all 4 heart valves simultaneously with retrospective valve-tracking during off-line analysis in healthy volunteers and in patients with valvular regurgitation. M...
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| Veröffentlicht in: | Investigative radiology 2009-10, Vol.44 (10), p.669-675 |
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| creator | Roes, Stijntje D Hammer, Sebastiaan van der Geest, Rob J Marsan, Nina Ajmone Bax, Jeroen J Lamb, Hildo J Reiber, Johan H. C de Roos, Albert Westenberg, Jos J. M |
| description | OBJECTIVES:To validate 3-dimensional (3D) 3-directional velocity-encoded (VE) magnetic resonance imaging (MRI) for flow assessment through all 4 heart valves simultaneously with retrospective valve-tracking during off-line analysis in healthy volunteers and in patients with valvular regurgitation.
MATERIAL AND METHODS:Three-dimensional 3-directional VE MRI was performed in 22 healthy volunteers and in 29 patients with ischemic cardiomyopathy who were suspected of valvular regurgitation and net flow volumes through the 4 heart valves were compared. Furthermore, the analysis was repeated for each valve in 10 healthy volunteers and in 10 regurgitant valves to assess intra- and interobserver agreement for assessment of respectively net flow volumes and regurgitation fraction.
RESULTS:In healthy volunteers, the average net flow volume through the mitral valve, tricuspid valve, aortic valve, and pulmonary valve was 85 ± 20 mL, 85 ± 21 mL, 83 ± 19 mL, 82 ± 21 mL, respectively. Strong correlations between net flow volumes through the 4 heart valves were observed (intraclass correlation coefficients [ICC] 0.93–0.95) and the coefficient of variance (CV) was small (6%–9%). The repeated analysis by the same observer and by a second observer yielded good agreement for measurement of net flow volumes (ICC0.93–0.99 and CV3%–7%). Strong correlations between the net flow volumes through the 4 heart valves were also observed in the patients with valvular regurgitation (ICC0.85–0.95 and CV7%–18%). The average net flow volume through the mitral valve, tricuspid valve, aortic valve, and pulmonary valve was 63 ± 20 mL, 63 ± 20 mL, 63 ± 20 mL, 63 ± 20 mL, respectively. Furthermore, the intra- and interobserver agreement for assessment of regurgitation fraction was good (ICC0.86 and 0.85, CV12% and 13%).
CONCLUSIONS:Flow assessment using 3D 3-directional VE MR with retrospective valve-tracking during off-line analysis enables accurate quantification of net flow volumes through 4 heart valves within a single acquisition in healthy volunteers and in patients with valvular regurgitation. |
| doi_str_mv | 10.1097/RLI.0b013e3181ae99b5 |
| format | Article |
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MATERIAL AND METHODS:Three-dimensional 3-directional VE MRI was performed in 22 healthy volunteers and in 29 patients with ischemic cardiomyopathy who were suspected of valvular regurgitation and net flow volumes through the 4 heart valves were compared. Furthermore, the analysis was repeated for each valve in 10 healthy volunteers and in 10 regurgitant valves to assess intra- and interobserver agreement for assessment of respectively net flow volumes and regurgitation fraction.
RESULTS:In healthy volunteers, the average net flow volume through the mitral valve, tricuspid valve, aortic valve, and pulmonary valve was 85 ± 20 mL, 85 ± 21 mL, 83 ± 19 mL, 82 ± 21 mL, respectively. Strong correlations between net flow volumes through the 4 heart valves were observed (intraclass correlation coefficients [ICC] 0.93–0.95) and the coefficient of variance (CV) was small (6%–9%). The repeated analysis by the same observer and by a second observer yielded good agreement for measurement of net flow volumes (ICC0.93–0.99 and CV3%–7%). Strong correlations between the net flow volumes through the 4 heart valves were also observed in the patients with valvular regurgitation (ICC0.85–0.95 and CV7%–18%). The average net flow volume through the mitral valve, tricuspid valve, aortic valve, and pulmonary valve was 63 ± 20 mL, 63 ± 20 mL, 63 ± 20 mL, 63 ± 20 mL, respectively. Furthermore, the intra- and interobserver agreement for assessment of regurgitation fraction was good (ICC0.86 and 0.85, CV12% and 13%).
CONCLUSIONS:Flow assessment using 3D 3-directional VE MR with retrospective valve-tracking during off-line analysis enables accurate quantification of net flow volumes through 4 heart valves within a single acquisition in healthy volunteers and in patients with valvular regurgitation.</description><identifier>ISSN: 0020-9996</identifier><identifier>EISSN: 1536-0210</identifier><identifier>DOI: 10.1097/RLI.0b013e3181ae99b5</identifier><identifier>PMID: 19724233</identifier><language>eng</language><publisher>United States: Lippincott Williams & Wilkins, Inc</publisher><subject>Adult ; Aortic Valve Insufficiency - diagnosis ; Aortic Valve Insufficiency - physiopathology ; Blood Flow Velocity ; Female ; Humans ; Image Enhancement - methods ; Image Interpretation, Computer-Assisted - methods ; Magnetic Resonance Imaging - methods ; Male ; Middle Aged ; Mitral Valve Insufficiency - diagnosis ; Mitral Valve Insufficiency - physiopathology ; Pulmonary Valve Insufficiency - diagnosis ; Pulmonary Valve Insufficiency - physiopathology ; Reproducibility of Results ; Retrospective Studies ; Sensitivity and Specificity ; Tricuspid Valve Insufficiency - diagnosis ; Tricuspid Valve Insufficiency - physiopathology</subject><ispartof>Investigative radiology, 2009-10, Vol.44 (10), p.669-675</ispartof><rights>2009 Lippincott Williams & Wilkins, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c2855-622eac42a3b9e8002eb85b2221eb8f7000e7494f6c4984c1323b7b68a94b10653</citedby><cites>FETCH-LOGICAL-c2855-622eac42a3b9e8002eb85b2221eb8f7000e7494f6c4984c1323b7b68a94b10653</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,27905,27906</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19724233$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Roes, Stijntje D</creatorcontrib><creatorcontrib>Hammer, Sebastiaan</creatorcontrib><creatorcontrib>van der Geest, Rob J</creatorcontrib><creatorcontrib>Marsan, Nina Ajmone</creatorcontrib><creatorcontrib>Bax, Jeroen J</creatorcontrib><creatorcontrib>Lamb, Hildo J</creatorcontrib><creatorcontrib>Reiber, Johan H. C</creatorcontrib><creatorcontrib>de Roos, Albert</creatorcontrib><creatorcontrib>Westenberg, Jos J. M</creatorcontrib><title>Flow Assessment Through Four Heart Valves Simultaneously Using 3-Dimensional 3-Directional Velocity-Encoded Magnetic Resonance Imaging With Retrospective Valve Tracking in Healthy Volunteers and Patients With Valvular Regurgitation</title><title>Investigative radiology</title><addtitle>Invest Radiol</addtitle><description>OBJECTIVES:To validate 3-dimensional (3D) 3-directional velocity-encoded (VE) magnetic resonance imaging (MRI) for flow assessment through all 4 heart valves simultaneously with retrospective valve-tracking during off-line analysis in healthy volunteers and in patients with valvular regurgitation.
MATERIAL AND METHODS:Three-dimensional 3-directional VE MRI was performed in 22 healthy volunteers and in 29 patients with ischemic cardiomyopathy who were suspected of valvular regurgitation and net flow volumes through the 4 heart valves were compared. Furthermore, the analysis was repeated for each valve in 10 healthy volunteers and in 10 regurgitant valves to assess intra- and interobserver agreement for assessment of respectively net flow volumes and regurgitation fraction.
RESULTS:In healthy volunteers, the average net flow volume through the mitral valve, tricuspid valve, aortic valve, and pulmonary valve was 85 ± 20 mL, 85 ± 21 mL, 83 ± 19 mL, 82 ± 21 mL, respectively. Strong correlations between net flow volumes through the 4 heart valves were observed (intraclass correlation coefficients [ICC] 0.93–0.95) and the coefficient of variance (CV) was small (6%–9%). The repeated analysis by the same observer and by a second observer yielded good agreement for measurement of net flow volumes (ICC0.93–0.99 and CV3%–7%). Strong correlations between the net flow volumes through the 4 heart valves were also observed in the patients with valvular regurgitation (ICC0.85–0.95 and CV7%–18%). The average net flow volume through the mitral valve, tricuspid valve, aortic valve, and pulmonary valve was 63 ± 20 mL, 63 ± 20 mL, 63 ± 20 mL, 63 ± 20 mL, respectively. Furthermore, the intra- and interobserver agreement for assessment of regurgitation fraction was good (ICC0.86 and 0.85, CV12% and 13%).
CONCLUSIONS:Flow assessment using 3D 3-directional VE MR with retrospective valve-tracking during off-line analysis enables accurate quantification of net flow volumes through 4 heart valves within a single acquisition in healthy volunteers and in patients with valvular regurgitation.</description><subject>Adult</subject><subject>Aortic Valve Insufficiency - diagnosis</subject><subject>Aortic Valve Insufficiency - physiopathology</subject><subject>Blood Flow Velocity</subject><subject>Female</subject><subject>Humans</subject><subject>Image Enhancement - methods</subject><subject>Image Interpretation, Computer-Assisted - methods</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mitral Valve Insufficiency - diagnosis</subject><subject>Mitral Valve Insufficiency - physiopathology</subject><subject>Pulmonary Valve Insufficiency - diagnosis</subject><subject>Pulmonary Valve Insufficiency - physiopathology</subject><subject>Reproducibility of Results</subject><subject>Retrospective Studies</subject><subject>Sensitivity and Specificity</subject><subject>Tricuspid Valve Insufficiency - diagnosis</subject><subject>Tricuspid Valve Insufficiency - physiopathology</subject><issn>0020-9996</issn><issn>1536-0210</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9Uc1uEzEYtBCIhsIbIOQbp239s38-VqWhkVKBShqOK6_zZWPqtVPb2yhPzGvg7UZC4sDJ_qyZ-cYzCH2k5IISUV3eLxcXpCWUA6c1lSBEW7xCM1rwMiOMktdoRggjmRCiPEPvQvhF0lwR_hadUVGxnHE-Q7_nxh3wVQgQQg824tXOu6Hb4bkbPL4F6SNeS_MMAf_Q_WCitOCGYI74IWjbYZ590YkXtLPSvEweVJymNRindDxmN1a5DWzwnewsRK3wPYSEsArwopfdqPNTx116jt6F_SjwDNNavPJSPY4IbUc7Ju6OeO3MYCOAD1jaDf4uo07WwyQy0gYjfVLrBt_pKEc779GbrTQBPpzOc_Qwv1ld32bLb18X11fLTLG6KLKSMZAqZ5K3AuqUF7R10TLGaLpsq5QgVLnIt6XKRZ0ryhlvq7aspchbSsqCn6PPk-7eu6cBQmx6HRQYM-XWVJzXNRFFnpD5hFTpz8HDttl73Ut_bChpxoab1HDzb8OJ9um0YGh72PwlnSpNgHoCHJyJKaJHMxzAN7uX7P6v_Qcy07qu</recordid><startdate>200910</startdate><enddate>200910</enddate><creator>Roes, Stijntje D</creator><creator>Hammer, Sebastiaan</creator><creator>van der Geest, Rob J</creator><creator>Marsan, Nina Ajmone</creator><creator>Bax, Jeroen J</creator><creator>Lamb, Hildo J</creator><creator>Reiber, Johan H. C</creator><creator>de Roos, Albert</creator><creator>Westenberg, Jos J. M</creator><general>Lippincott Williams & Wilkins, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200910</creationdate><title>Flow Assessment Through Four Heart Valves Simultaneously Using 3-Dimensional 3-Directional Velocity-Encoded Magnetic Resonance Imaging With Retrospective Valve Tracking in Healthy Volunteers and Patients With Valvular Regurgitation</title><author>Roes, Stijntje D ; Hammer, Sebastiaan ; van der Geest, Rob J ; Marsan, Nina Ajmone ; Bax, Jeroen J ; Lamb, Hildo J ; Reiber, Johan H. C ; de Roos, Albert ; Westenberg, Jos J. M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2855-622eac42a3b9e8002eb85b2221eb8f7000e7494f6c4984c1323b7b68a94b10653</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Adult</topic><topic>Aortic Valve Insufficiency - diagnosis</topic><topic>Aortic Valve Insufficiency - physiopathology</topic><topic>Blood Flow Velocity</topic><topic>Female</topic><topic>Humans</topic><topic>Image Enhancement - methods</topic><topic>Image Interpretation, Computer-Assisted - methods</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mitral Valve Insufficiency - diagnosis</topic><topic>Mitral Valve Insufficiency - physiopathology</topic><topic>Pulmonary Valve Insufficiency - diagnosis</topic><topic>Pulmonary Valve Insufficiency - physiopathology</topic><topic>Reproducibility of Results</topic><topic>Retrospective Studies</topic><topic>Sensitivity and Specificity</topic><topic>Tricuspid Valve Insufficiency - diagnosis</topic><topic>Tricuspid Valve Insufficiency - physiopathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Roes, Stijntje D</creatorcontrib><creatorcontrib>Hammer, Sebastiaan</creatorcontrib><creatorcontrib>van der Geest, Rob J</creatorcontrib><creatorcontrib>Marsan, Nina Ajmone</creatorcontrib><creatorcontrib>Bax, Jeroen J</creatorcontrib><creatorcontrib>Lamb, Hildo J</creatorcontrib><creatorcontrib>Reiber, Johan H. C</creatorcontrib><creatorcontrib>de Roos, Albert</creatorcontrib><creatorcontrib>Westenberg, Jos J. M</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Investigative radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Roes, Stijntje D</au><au>Hammer, Sebastiaan</au><au>van der Geest, Rob J</au><au>Marsan, Nina Ajmone</au><au>Bax, Jeroen J</au><au>Lamb, Hildo J</au><au>Reiber, Johan H. C</au><au>de Roos, Albert</au><au>Westenberg, Jos J. M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Flow Assessment Through Four Heart Valves Simultaneously Using 3-Dimensional 3-Directional Velocity-Encoded Magnetic Resonance Imaging With Retrospective Valve Tracking in Healthy Volunteers and Patients With Valvular Regurgitation</atitle><jtitle>Investigative radiology</jtitle><addtitle>Invest Radiol</addtitle><date>2009-10</date><risdate>2009</risdate><volume>44</volume><issue>10</issue><spage>669</spage><epage>675</epage><pages>669-675</pages><issn>0020-9996</issn><eissn>1536-0210</eissn><abstract>OBJECTIVES:To validate 3-dimensional (3D) 3-directional velocity-encoded (VE) magnetic resonance imaging (MRI) for flow assessment through all 4 heart valves simultaneously with retrospective valve-tracking during off-line analysis in healthy volunteers and in patients with valvular regurgitation.
MATERIAL AND METHODS:Three-dimensional 3-directional VE MRI was performed in 22 healthy volunteers and in 29 patients with ischemic cardiomyopathy who were suspected of valvular regurgitation and net flow volumes through the 4 heart valves were compared. Furthermore, the analysis was repeated for each valve in 10 healthy volunteers and in 10 regurgitant valves to assess intra- and interobserver agreement for assessment of respectively net flow volumes and regurgitation fraction.
RESULTS:In healthy volunteers, the average net flow volume through the mitral valve, tricuspid valve, aortic valve, and pulmonary valve was 85 ± 20 mL, 85 ± 21 mL, 83 ± 19 mL, 82 ± 21 mL, respectively. Strong correlations between net flow volumes through the 4 heart valves were observed (intraclass correlation coefficients [ICC] 0.93–0.95) and the coefficient of variance (CV) was small (6%–9%). The repeated analysis by the same observer and by a second observer yielded good agreement for measurement of net flow volumes (ICC0.93–0.99 and CV3%–7%). Strong correlations between the net flow volumes through the 4 heart valves were also observed in the patients with valvular regurgitation (ICC0.85–0.95 and CV7%–18%). The average net flow volume through the mitral valve, tricuspid valve, aortic valve, and pulmonary valve was 63 ± 20 mL, 63 ± 20 mL, 63 ± 20 mL, 63 ± 20 mL, respectively. Furthermore, the intra- and interobserver agreement for assessment of regurgitation fraction was good (ICC0.86 and 0.85, CV12% and 13%).
CONCLUSIONS:Flow assessment using 3D 3-directional VE MR with retrospective valve-tracking during off-line analysis enables accurate quantification of net flow volumes through 4 heart valves within a single acquisition in healthy volunteers and in patients with valvular regurgitation.</abstract><cop>United States</cop><pub>Lippincott Williams & Wilkins, Inc</pub><pmid>19724233</pmid><doi>10.1097/RLI.0b013e3181ae99b5</doi><tpages>7</tpages></addata></record> |
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| subjects | Adult Aortic Valve Insufficiency - diagnosis Aortic Valve Insufficiency - physiopathology Blood Flow Velocity Female Humans Image Enhancement - methods Image Interpretation, Computer-Assisted - methods Magnetic Resonance Imaging - methods Male Middle Aged Mitral Valve Insufficiency - diagnosis Mitral Valve Insufficiency - physiopathology Pulmonary Valve Insufficiency - diagnosis Pulmonary Valve Insufficiency - physiopathology Reproducibility of Results Retrospective Studies Sensitivity and Specificity Tricuspid Valve Insufficiency - diagnosis Tricuspid Valve Insufficiency - physiopathology |
| title | Flow Assessment Through Four Heart Valves Simultaneously Using 3-Dimensional 3-Directional Velocity-Encoded Magnetic Resonance Imaging With Retrospective Valve Tracking in Healthy Volunteers and Patients With Valvular Regurgitation |
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