Gulsin G S, Singh A, McCann G P
Department of Cardiovascular Sciences, University of Leicester and the NIHR Biomedical Research Centre, Glenfield Hospital, Groby Road, Leicester, UK.
BMC Med Imaging. 2017 Dec 29;17(1):67. doi: 10.1186/s12880-017-0238-0.
Over the last 25 years, cardiovascular magnetic resonance imaging (CMR) has emerged as an alternative to echocardiography for assessment of valvular heart disease (VHD). Although echo remains the first-line imaging modality for the assessment of patients with VHD, CMR can now provide a comprehensive assessment in many instances. Using a combination of techniques, CMR provides information on valve anatomy and enables quantitative analysis of the severity of the valve lesion.
In this review, the fundamentals of CMR in assessment of VHD are described, together with its strengths and weaknesses. We detail the utility of CMR for studying all aspects of VHD, including valve anatomy, flow quantification as well as ventricular volumes and function. The optimisation of CMR for evaluating the commonest valve lesions (aortic stenosis, aortic regurgitation, mitral regurgitation, mitral stenosis) as well as in right-sided VHD and prosthetic valves is summarised. The focus of this review is to enable the reader to optimise the use of CMR in his or her own evaluation of heart valve lesions in clinical practice.
CMR can be used for the comprehensive evaluation of VHD. This exciting, non-invasive imaging modality is likely to have increasing utility in the clinical evaluation of patients with VHD.
在过去25年中,心血管磁共振成像(CMR)已成为评估瓣膜性心脏病(VHD)的超声心动图替代方法。尽管超声仍然是评估VHD患者的一线成像方式,但CMR现在在许多情况下可以提供全面评估。通过结合多种技术,CMR可提供瓣膜解剖结构信息,并能对瓣膜病变的严重程度进行定量分析。
在本综述中,描述了CMR评估VHD的基本原理及其优缺点。我们详细阐述了CMR在研究VHD各个方面的实用性,包括瓣膜解剖结构、血流定量以及心室容积和功能。总结了CMR评估最常见瓣膜病变(主动脉瓣狭窄、主动脉瓣反流、二尖瓣反流、二尖瓣狭窄)以及右侧VHD和人工瓣膜时的优化方法。本综述的重点是使读者能够在临床实践中优化CMR在其自身对心脏瓣膜病变评估中的应用。
CMR可用于VHD的全面评估。这种令人兴奋的非侵入性成像方式在VHD患者的临床评估中可能会有越来越大的用途。