Speiser Uwe, Quick Silvio, Haas David, Youssef Akram, Waessnig Nadine K, Ibrahim Karim, Strasser Ruth H, Schoen Steffen
Technische Universität Dresden, Medizinische Fakultät Carl Gustav Carus , Herzzentrum Dresden, Universitätsklinik, Klinik für Innere Medizin und Kardiologie, Dresden , Germany.
Scand Cardiovasc J. 2014 Jun;48(3):176-83. doi: 10.3109/14017431.2014.906646. Epub 2014 Apr 29.
For evaluation of aortic valve area (AVA), transthoracic echocardiography (TTE) is the method of choice. Cardiac magnetic resonance (CMR) at 1.5-Tesla is an alternative. The aim of the study was to check whether quantification of whole range of AVA without severe aortic stenosis is possible and reliable in higher magnetic field strength, and also including a comparison to TTE.
In 3-T CMR phase contrast sequences were assessed above aortic valve and left ventricular output tract. AVA was calculated using the continuity equation. Planimetric analysis of AVA was performed in magnitude images. TTE was used as reference method for graduation of AVA.
Totally 48 patients (64 ± 18 years) without severe aortic valve stenosis were prospectively enrolled. In CMR planimetric AVA was 2.5 ± 1.3 cm(2) and calculated AVA 2.4 ± 1.3 cm(2), whereas AVA in TTE was 1.9 ± 1.1 cm(2). Planimetric and calculated AVA in CMR and also AVA in CMR and TTE showed good correlation (r = 0.97, 0.92, respectively). Bland-Altman analysis demonstrated no signs of over- or underestimation. Inter- and intraobserver variabilities were low.
Determination of AVA using 3-T CMR is possible using direct planimetry and continuity equation. CMR is the alternative first choice method in cases with discrepant or insufficient echocardiographic results.
对于主动脉瓣面积（AVA）的评估，经胸超声心动图（TTE）是首选方法。1.5特斯拉的心脏磁共振成像（CMR）是一种替代方法。本研究的目的是检验在更高磁场强度下，对无严重主动脉瓣狭窄的整个AVA范围进行量化是否可行且可靠，同时与TTE进行比较。
在3-T CMR中，评估主动脉瓣上方和左心室流出道的相位对比序列。使用连续性方程计算AVA。在幅度图像上对AVA进行平面测量分析。TTE用作AVA分级的参考方法。
前瞻性纳入了48例无严重主动脉瓣狭窄的患者（64±18岁）。在CMR中，平面测量的AVA为2.5±1.3 cm²，计算得出的AVA为2.4±1.3 cm²，而TTE中的AVA为1.9±1.1 cm²。CMR中平面测量和计算得出的AVA以及CMR和TTE中的AVA均显示出良好的相关性（分别为r = 0.97和0.92）。Bland-Altman分析未显示高估或低估的迹象。观察者间和观察者内的变异性较低。
使用3-T CMR通过直接平面测量法和连续性方程来测定AVA是可行的。在超声心动图结果不一致或不足的情况下，CMR是替代的首选方法。
