Krombach Gabriele A, Kühl Harald, Bücker Arno, Mahnken Andreas H, Spüntrup Elmar, Lipke Claudia, Schröder Jörg, Günther Rolf W
Department of Diagnostic Radiology, University of Technology, Aachen, Germany.
J Magn Reson Imaging. 2004 Jan;19(1):59-67. doi: 10.1002/jmri.10428.
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).
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).
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).
The results of this study suggest that valvular dysfunction can be semiquantitatively assessed using SSFP cine MR imaging.
评估稳态自由进动快速成像（SSFP）电影序列对心脏瓣膜功能不全进行半定量评估的价值，并将结果与标准屏气分段梯度回波平面成像序列（GE-EPI）所得结果进行比较。
23例已知瓣膜功能不全患者（主要类型：16例主动脉瓣狭窄、9例主动脉瓣关闭不全、3例二尖瓣狭窄、2例二尖瓣反流、2例三尖瓣反流、1例肺动脉狭窄）和23例瓣膜功能正常的对照者在1.5-T系统（ACS-NT，飞利浦公司，荷兰贝斯特）上接受磁共振成像检查。在相同的长轴视图下采集SSFP电影序列和GE-EPI图像。由两名经验丰富的放射科医生评估瓣膜信号缺失的存在及范围以及图像质量的一致性。将结果与通过心导管检查（16例患者）或彩色多普勒检查（其余7例患者）获得的结果进行比较。
在SSFP图像上，瓣膜反流或狭窄病变中的复杂血流模式在所有患者中均导致心房或心室明亮血池内出现信号缺失，与GE-EPI图像相似。使用SSFP对瓣膜功能不全进行诊断的敏感性与使用GE-EPI序列时相同，均为100%。结果与心导管检查或彩色多普勒超声检查结果相关（P<0.001，r = 0.97）。然而，在5例患者中，GE-EPI上的喷射现象略为明显。在23例对照者中，两种序列均未发现明显信号缺失。在所有46例受试者中，SSFP图像的质量评分高于GE-EPI（P<0.05；SSFP为2.6±0.1，评分范围为0 - 3；GE-EPI为1.7±0.1）。
本研究结果表明，可使用SSFP电影磁共振成像对瓣膜功能不全进行半定量评估。
