Quantification of aortic valve stenosis in MRI-comparison of steady-state free precession and fast low-angle shot sequences.
We compared two different magnetic resonance (MR) sequences [steady-state free precession (SSFP) and gradient echo fast low-angle shot (FLASH)] for the assessment of aortic valve areas in aortic stenosis using transesophageal echocardiography (TEE) as the standard of reference. Thirty-two patients with known aortic stenosis underwent MR (1.5 T) using a cine SSFP sequence and a cine FLASH sequence. Planimetry was performed in cross-sectional images and compared to the results of the TEE. In seven patients the grade of stenosis was additionally assessed by invasive cardiac catheterization (ICC). The mean aortic valve area measured by TEE was 0.97+/-0.19 mm(2), 1.00+/-0.25 mm(2) for SSFP and 1.25+/-0.23 mm(2) based on FLASH images. The mean difference between the valve areas assessed based on SSFP and TEE images was 0.15+/-0.13 cm(2) (FLASH vs TEE: 0.29+/-0.17 cm(2)). Bland-Altman analysis demonstrated that measurements using FLASH images overestimated the aortic valve area compared to TEE. Comparing ICC with MRI and TEE, only a weak to moderate correlation was found (ICC vs TEE: R=0.52, p=0.22; ICC vs SSFP: R=0.20, p=0.65; ICC vs FLASH: R=0.16, p=0.70). Measurements of the aortic valve area based on SSFP images correlate better with TEE compared to FLASH images.
Schlosser
Thomas
T
Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstr. 55, 45122, Essen, Germany. thomas.schlosser@uni-essen.de
Malyar
Nasser
N
Jochims
Markus
M
Breuckmann
Frank
F
Hunold
Peter
P
Bruder
Oliver
O
Erbel
Raimund
R
Barkhausen
Jörg
J
D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000473:pathology*; D006328:Cardiac Catheterization; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged