title: Cine MR imaging of heart valve dysfunction with segmented true fast imaging with steady state free precession.
abstract: OBJECTIVE
  To evaluate the value of cine true fast imaging with steady-state free precession (SSFP) for semiquantitative assessment of valvular dysfunction in the heart and to compare the results to that obtained with a standard breath-hold segmented gradient-recalled echo-planar imaging sequence (GE-EPI).
  
  
  METHODS
  Twenty-three patients with known valvular dysfunction (main component: 16 with aortic valve stenosis, nine with aortic valve insufficiency, three with mitral stenosis, two with mitral regurgitation, two with tricuspidal regurgitation, and one with pulmonary stenosis) and 23 control subjects with normal valvular function underwent MR imaging on a 1.5-T system (ACS-NT, Philips, Best, The Netherlands). Cine SSFP and GE-EPI images were acquired in identical long-axis views. Images were evaluated for the presence and extent of the signal void arising from the valves and for image quality consensus by two experienced radiologists. Results were compared to those obtained by cardiac catheterization (in 16 patients) or color Doppler (in the remaining seven patients).
  
  
  RESULTS
  On SSPF images, the complex flow pattern in valvular regurgitant or stenotic lesions caused signal void within the bright blood pool of the atria or ventricles, similar to GE-EPI, in all patients. Valvular dysfunction was delineated using SSFP with the same high sensitivity (100%) as using the GE-EPI sequence. Results correlated to those obtained by cardiac catheterization or color Doppler ultrasonography (P < 0.001, r = 0.97). However, the jet phenomenon was slightly more pronounced in five patients on GE-EPI. There was no significant signal void in the 23 control subjects with both sequences. In all 46 subjects, the image quality of SSFP images was rated higher (P < 0.05; 2.6 +/- 0.1; using a scale ranging from 0-3) compared to GE-EPI (1.7 +/- 0.1).
  
  
  CONCLUSIONS
  The results of this study suggest that valvular dysfunction can be semiquantitatively assessed using SSFP cine MR imaging.
authors.affiliation: Department of Diagnostic Radiology, University of Technology, Aachen, Germany. krombach@rad.rwth-aachen.de
authors.forename: Gabriele A
authors.initials: GA
authors.lastname: Krombach
authors.forename: Harald
authors.initials: H
authors.lastname: Kühl
authors.forename: Arno
authors.initials: A
authors.lastname: Bücker
authors.forename: Andreas H
authors.initials: AH
authors.lastname: Mahnken
authors.forename: Elmar
authors.initials: E
authors.lastname: Spüntrup
authors.forename: Claudia
authors.initials: C
authors.lastname: Lipke
authors.forename: Jörg
authors.initials: J
authors.lastname: Schröder
authors.forename: Rolf W
authors.initials: RW
authors.lastname: Günther
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D006328:Cardiac Catheterization; D016022:Case-Control Studies; D017352:Echo-Planar Imaging; D004452:Echocardiography; D005260:Female; D006349:Heart Valve Diseases / Q000503:physiopathology*; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity