Nishimura F, Yoshino Y, Mihara J, Kamiya H, Ichikawa S, Kimura M
Department of Cardiology, Kameda General Hospital, Kamogawa, Japan.
Jpn Circ J. 1990 Mar;54(3):288-91. doi: 10.1253/jcj.54.288.
It is well known that the regurgitant blood flow of valvular disease shows a low intensity signal (LS) in cine-MR imaging (cMRI). To determine the significance of cMRI in evaluation of valvular regurgitation, 104 patients who had been assessed by cineangiography also underwent oblique cMRI for mitral regurgitation (MR) and aortic regurgitation (AR), and transverse cMRI for tricuspid regurgitation (TR). In evaluating the accuracy of diagnosis of valvular regurgitation on the basis of the presence of LS in the recipient chamber, sensitivity was found to be 93.5% for MR, 100% for AR and 85.7% for TR; specificity was 76.9% for MR and 100% for AR. The length and area of LS were planimetered in any view with the largest area, and its ratios to the length and area of the recipient chamber of view were calculated. Each index was significantly higher than the degree calculated by cineangiography. The best correlation with angiography was the ratio of the area of LS to the recipient chamber, and a semiquantitative classification by the index was coincident with angiographic severity in 38 of 43 (88.4%) patients undergoing MR, and in 28 of 30 (93.3%) patients undergoing AR. Thus, cMRI is a clinically useful noninvasive method in the identification and semiquantitative assessment of regurgitation severity.
众所周知，在电影磁共振成像（cMRI）中，瓣膜病的反流血流显示为低强度信号（LS）。为了确定cMRI在评估瓣膜反流中的意义，104例已通过心血管造影评估的患者还接受了用于二尖瓣反流（MR）和主动脉瓣反流（AR）的斜位cMRI，以及用于三尖瓣反流（TR）的横位cMRI。在根据受血腔内LS的存在评估瓣膜反流诊断的准确性时，发现MR的敏感性为93.5%，AR为100%，TR为85.7%；MR的特异性为76.9%，AR为100%。在任何具有最大面积的视图中用面积计测量LS的长度和面积，并计算其与该视图受血腔长度和面积的比值。每个指标均显著高于心血管造影计算的程度。与血管造影相关性最好的是LS面积与受血腔的比值，并且在43例接受MR的患者中有38例（88.4%）以及在30例接受AR的患者中有28例（93.3%），根据该指标进行的半定量分类与血管造影严重程度一致。因此，cMRI是一种在识别和半定量评估反流严重程度方面临床上有用的非侵入性方法。
