title: Multi-parametric quantification of tricuspid regurgitation using cardiovascular magnetic resonance: A comparison to echocardiography.
abstract: BACKGROUND
  Velocity-encoding is used to quantify tricuspid regurgitation (TR) by cardiovascular magnetic resonance (CMR), but requires additional dedicated imaging. We hypothesized that size and signal intensity (SI) of the cross-sectional TR jet area in the right atrium in short-axis steady-state free-precession images could be used to assess TR severity.
  
  
  METHODS
  We studied 61 patients with TR, who underwent CMR and echocardiography within 24h. TR severity was determined by vena contracta: severe (N=20), moderate or mild (N=41). CMR TR jet area and normalized SI were measured in the plane and frame that depicted maximum area. ROC analysis was performed in 21/61 patients to determine diagnostic accuracy of differentiating degrees of TR. Optimal cutoffs were independently tested in the remaining 40 patients.
  
  
  RESULTS
  Measurable regions of signal loss depicting TR jets were noted in 51/61 patients, while 9/10 remaining patients had mild TR by echocardiography. With increasing TR severity, jet area significantly increased (15±14 to 38±20mm2), while normalized SI decreased (57±27 to 23±11). ROC analysis showed high AUC values in the derivation group and good accuracy in the test group.
  
  
  CONCLUSIONS
  TR can be quantified from short-axis CMR images in agreement with echocardiography, while circumventing additional image acquisition.
authors.affiliation: Department of Medicine, University of Chicago Medical Center, Chicago, IL, USA.
authors.forename: Diego
authors.initials: D
authors.lastname: Medvedofsky
authors.affiliation: Complejo Hospitalario Universitario de Huelva, Huelva, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: León Jiménez
authors.affiliation: Department of Medicine, University of Chicago Medical Center, Chicago, IL, USA.
authors.forename: Karima
authors.initials: K
authors.lastname: Addetia
authors.affiliation: Department of Medicine, University of Chicago Medical Center, Chicago, IL, USA.
authors.forename: Amita
authors.initials: A
authors.lastname: Singh
authors.affiliation: Department of Medicine, University of Chicago Medical Center, Chicago, IL, USA.
authors.forename: Roberto M
authors.initials: RM
authors.lastname: Lang
authors.affiliation: Department of Medicine, University of Chicago Medical Center, Chicago, IL, USA. Electronic address: vmoravi@bsd.uchicago.edu.
authors.forename: Victor
authors.initials: V
authors.lastname: Mor-Avi
authors.affiliation: Department of Medicine, University of Chicago Medical Center, Chicago, IL, USA.
authors.forename: Amit R
authors.initials: AR
authors.lastname: Patel
mesh_terms: D003430:Cross-Sectional Studies; D004452:Echocardiography / Q000379:methods; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012372:ROC Curve; D014262:Tricuspid Valve Insufficiency / Q000175:diagnosis*
keywords: Cardiac imaging; Cardiac magnetic resonance imaging; Quantification; Tricuspid regurgitation; Valvular heart disease