Diagnostic accuracy and estimation of the severity of valvular regurgitation from the signal void on cine magnetic resonance images.

ABSTRACT

Anomalous blood flow caused by valvular regurgitation can be visualized as a narrowly defined area of signal loss in contrast to the high intensity of the blood pool on repetitive gradient refocused magnetic resonance (MRI) (cine MRI) views. In order to assess the accuracy of identification and measurements of the signal void in the evaluation of mitral (MR) and aortic regurgitation (AR), the cine MRI studies of 62 patients with regurgitation and of 20 normal volunteers were retrospectively analyzed in a blinded study of three independent reviewers. Accuracy for detection of MR was greater than 0.96 and for AR was greater than 0.91 for all three reviewers. The total volume of the signal void associated with regurgitation was measured on cine MRI images of 58 patients by two independent observers. The patients were divided into three groups of severity based upon assessment of severity of regurgitation by two-dimensional echocardiography and/or angiography. The total volume of signal loss was 9.0 ml (+/- 0.94 SEE; n = 18) for mild MR, 30.7 ml (+/- 5.3 SEE; n = 11) for moderate MR, and 83.4 ml (+/- 17.4 SEE; n = 5) for severe MR. In patients with AR, the calculated signal void was 27.3 ml (+/- 3.2 SEE; n = 24) in mild, 49.7 ml (+/- 2.9 SEE; n = 7) in moderate, and 75.8 ml (+/- 5.7; n = 6) in severe cases. The differences in the volume of the signal void were significant among the three groups of severity (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)