title: Three-dimensional dynamic assessment of tricuspid and mitral annuli using cardiovascular magnetic resonance.
abstract: OBJECTIVE
  To explore the potentiality of cardiovascular magnetic resonance (CMR) in the quantitative evaluation of mitral valve annulus (MVA) and tricuspid valve annulus (TVA) morphology and dynamics.
  
  
  RESULTS
  CMR was performed in 13 normal subjects and 9 patients with mitral (n = 7) or tricuspid regurgitation (n = 2), acquiring cine-images in 18 radial long-axis planes passing through the middle of MVA or TVA. A novel algorithm was used to obtain dynamic three-dimensional (3D) reconstruction of MVA and TVA. Analysis was feasible in all cases, allowing accurate 3D annular reconstruction and tracking. The 3D area increased from systole [MVA, median = 10.0 cm(2) (first quartile = 8.6, third quartile = 11.4); TVA, 11.2 cm(2) (8.8-13.2)] to diastole [MVA, 10.6 cm(2) (9.4, 11.7); TVA, 11.9 cm(2) (9.2-13.5)], with TVA larger than MVA. While the longest diameter showed similar systolic and diastolic values, the shortest diameter elongated from systole [MVA, 30 mm (29-33); TVA, 33 mm (31-36)] to diastole [MVA, 31 mm (29-32); TVA, 36 mm (33-39)]. Also, TVA became more circular than MVA. TVA showed lower peak systolic excursion in the septal [15.9 mm (13.0-18.5)] and anterior regions [17.9 mm (12.2-20.7)] compared with the posterior [21.9 mm (18.6-24.0)] segment. Values in MVA were smaller than in TVA, slightly higher in anterior [11.2 mm (9.5-13.0)] than in posterior [12.4 mm (10.2-14.6)] segments. Valvular regurgitation was associated with enlarged, flattened, and more circular annuli.
  
  
  CONCLUSIONS
  The applied method was feasible and accurate in normal and regurgitant valves, and may potentially have an impact on diagnosis, improvement of surgical techniques and design of annular prostheses.
authors: Centro Cardiologico Monzino IRCCS, Via Parea 4, Milan 20138, Italy.
authors: Francesco
authors: F
authors: Maffessanti
authors: Paola
authors: P
authors: Gripari
authors: Gianluca
authors: G
authors: Pontone
authors: Daniele
authors: D
authors: Andreini
authors: Erika
authors: E
authors: Bertella
authors: Saima
authors: S
authors: Mushtaq
authors: Gloria
authors: G
authors: Tamborini
authors: Laura
authors: L
authors: Fusini
authors: Mauro
authors: M
authors: Pepi
authors: Enrico G
authors: EG
authors: Caiani
mesh_terms: D000328:Adult; D058385:Cardiac Valve Annuloplasty / Q000379:methods; D016022:Case-Control Studies; D002815:Chordae Tendineae / Q000033:anatomy & histology / Q000601:surgery; D015331:Cohort Studies; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000033:anatomy & histology* / Q000473:pathology / Q000601:surgery; D008944:Mitral Valve Insufficiency / Q000175:diagnosis*; D012016:Reference Values; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D014261:Tricuspid Valve / Q000033:anatomy & histology* / Q000473:pathology / Q000601:surgery; D014262:Tricuspid Valve Insufficiency / Q000175:diagnosis*
keywords: Annular geometry; Cardiovascular magnetic resonance; Mitral valve annulus; Tricuspid valve annulus