Planimetry of Mitral Valve Stenosis by Magnetic Resonance Imaging

• Published in: Journal of the American College of Cardiology Vol. 45; no. 12; pp. 2048 - 2053
• Main Authors: Djavidani, Behrus, Debl, Kurt, Lenhart, Markus, Seitz, Johannes, Paetzel, Christian, Schmid, Franz X., Nitz, Wolfgang R., Feuerbach, Stefan, Riegger, Günter, Luchner, Andreas
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 21.06.2005; Elsevier Science; Elsevier Limited
• Subjects: Accuracy; Acquisitions & mergers; Aged; Biological and medical sciences; Cardiac Catheterization; Cardiology; Cardiology. Vascular system; Cardiovascular disease; Confidence intervals; Endocardial and cardiac valvular diseases; Feasibility Studies; Female; Heart; Humans; Intubation; Magnetic Resonance Imaging; Male; Medical sciences; Methods; Middle Aged; Mitral Valve - diagnostic imaging; Mitral Valve - pathology; Mitral Valve Stenosis - diagnostic imaging; Mitral Valve Stenosis - pathology; NMR; Nuclear magnetic resonance; Predictive Value of Tests; Reproducibility of Results; Severity of Illness Index; Ultrasonography; MVA; ECHO; MRI; CATH; MS; Mitral valve; Cardiac valvular disease; Cardiovascular disease; Medical imagery; Circulatory system; Mitral stenosis; Cardiology; Nuclear magnetic resonance imaging; Phlebology; Planimetry
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/j.jacc.2005.03.036

We sought to determine whether noninvasive planimetry of the mitral valve area (MVA) by magnetic resonance imaging (MRI) is feasible and reliable in patients with mitral stenosis (MS). Accurate assessment of MVA is particularly important for the management of patients with valvular stenosis. Current standard techniques for assessing the severity of MS include echocardiography (ECHO) and cardiac catheterization (CATH). In 22 patients with suspected or known MS, planimetry of MVA was performed with a 1.5-T magnetic resonance scanner using a breath-hold balanced gradient echo sequence (true FISP). Data were compared with echocardiographically determined MVA (ECHO-MVA, n = 22), as well as with invasively calculated MVA by the Gorlin-formula at (CATH-MVA, n = 17). The correlation between MRI- and CATH-MVA was 0.89 (p < 0.0001), and the correlation between MRI- and ECHO-MVA was 0.81 (p < 0.0001). The MRI-MVA slightly overestimated CATH-MVA by 5.0% (1.60 ± 0.45 cm2vs. 1.52 ± 0.49 cm2, p = NS) and ECHO-MVA by 8.1% (1.61 ± 0.42 cm2vs. 1.48 ± 0.42 cm2, p < 0.05). On receiver-operating characteristic curve analysis, a value of MRI-MVA below 1.65 cm2indicated mitral stenosis (CATH-MVA ≤1.5 cm2), with a good sensitivity and specificity (89% and 75%, respectively). Magnetic resonance planimetry of the mitral valve orifice in mitral stenosis offers a reliable and safe method for noninvasive quantification of mitral stenosis. In the clinical management of patients with mitral stenosis, it has to be considered that planimetry by MRI slightly overestimates MVA, as compared with MVA calculated echocardiographically and at catheterization.