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Cardiovascular magnetic resonance imaging and transthoracic echocardiography in the assessment of stenotic aortic valve area: a comparative study
Department of Radiology, Örebro University Hospital , Örebro, Sweden.
Department of Clinical Physiology, Örebro University Hospital , Örebro, Sweden.
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Department of Clinical Physiology, Örebro University Hospital , Örebro, Sweden.
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Department of Medical Physics, Örebro University Hospital, Örebro, Sweden .ORCID iD: 0000-0002-8351-3367
2012 (English)In: Acta Radiologica, ISSN 0284-1851, E-ISSN 1600-0455, Vol. 53, no 9, p. 995-1003Article in journal (Refereed) Published
Abstract [en]

Background: Magnetic resonance (MR) imaging and echocardiography both allow assessment of aortic valve stenosis. In MR the aortic valve area (AvA) is measured using planimetry while in transthoracic echocardiography (TTE) AvA is usually calculated by applying the continuity equation.

Purpose: To compare the measured stenotic aortic valve areas using five different MR-acquisition alternatives with the corresponding area values calculated by TTE.

Material and Methods: The aortic valve was imaged in 14 patients, with diagnosed aortic valve stenosis, using balanced steady state free precession (bSSFP) gradient echo (GE) and phase contrast imaging (PC). Three adjacent slices were planned to encompass the aortic valve and the aortic valve area was measured using planimetry. The two sets of complex valued images generated by the PC sequence formed three kinds of images that could be used for aortic valve area measurements: the magnitude image (PC/Mag), the modulus (PCA/M), and phase difference (PCA/P) between the two complex images, respectively. The valve area from TTE was calculated using the continuity equation. A cut-off of <1.0 cm(2) was used as a criteria for severe stenosis.

Results: The mean area differences between the different MR acquisitions and TTE method were -0.05 ± 0.37 cm(2) (GE), -0.18 ± 0.46 cm(2) (bSSFP), 0.27 ± 0.43 cm(2) (PC/Mag), 0.15 ± 0.32 cm(2) (PCA/P), and 0.26 ± 0.27 cm(2) (PCA/M). The valve area was significantly overestimated using PCA/M that, in turn, implied a significant underestimation of the aortic valve stenosis severity compared to the assessments using TTE.

Conclusion: The smallest area valve difference between TTE and an MR-acquisition alternative is obtained with gradient echo images. The use of PCA/M leads to significant differences in planimetry measurements of the aortic valve orifice and the gradation of the stenosis severity compared to TTE.

Place, publisher, year, edition, pages
London, United Kingdom: Royal Society of Medicine Press, 2012. Vol. 53, no 9, p. 995-1003
Keywords [en]
Aortic valve stenosis, gradient echo, phase contrast imaging, balanced steady state free precession
National Category
Radiology, Nuclear Medicine and Medical Imaging
Research subject
Radiology
Identifiers
URN: urn:nbn:se:oru:diva-27170DOI: 10.1258/ar.2012.120261ISI: 000311596800007PubMedID: 22983258Scopus ID: 2-s2.0-84872020075OAI: oai:DiVA.org:oru-27170DiVA, id: diva2:601902
Note

Funding agency:

Research Committee of Örebro County Council 

Available from: 2013-01-30 Created: 2013-01-30 Last updated: 2017-12-06Bibliographically approved

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Emilsson, KentThunberg, Per

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