Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom; and the Department of Cardiology, John Radcliffe Hospital, Oxford, United Kingdom.
JACC Cardiovasc Imaging. 2021 Oct;14(10):2020-2032. doi: 10.1016/j.jcmg.2020.09.029. Epub 2020 Nov 25.
Cardiac magnetic resonance (CMR) is a versatile imaging tool that brings much to the assessment of valvular heart disease. Although it is best known for myocardial imaging (even in valve disease), it provides excellent assessment of all 4 heart valves, with some distinct advantages, including a free choice of image planes and accurate flow and volumetric quantification. These allow the severity of each valve lesion to be characterized, in addition to optimal visualization of the surrounding outflow tracts and vessels, to deliver a comprehensive package. It can assess each valve lesion separately (in multiple valve disease) and is not affected by hemodynamic status. The accurate quantitation of regurgitant lesions and the ability to characterize myocardial changes also provides an ability to predict future clinical outcomes in asymptomatic patients. This review outlines how CMR can be used in cardiac valve disease to compliment echocardiography and enhance the patient assessment. It covers the main CMR methods used, their strengths and limitations, and the optimal way to apply them to evaluate valve disease.
心脏磁共振（CMR）是一种多功能成像工具，在评估瓣膜性心脏病方面具有重要作用。尽管它最常用于心肌成像（即使在瓣膜疾病中），但它也能极好地评估所有 4 个心脏瓣膜，具有一些独特的优势，包括可自由选择成像平面以及准确的流量和容积定量。这些优势不仅允许对每个瓣膜病变的严重程度进行特征描述，还可以优化对周围流出道和血管的可视化，从而提供全面的评估。CMR 可以单独评估每个瓣膜病变（在多瓣膜疾病中），并且不受血流动力学状态的影响。准确定量反流病变的能力以及描述心肌变化的能力，也为无症状患者的未来临床结局提供了预测能力。这篇综述概述了 CMR 在心脏瓣膜疾病中的应用，以补充超声心动图并增强患者评估。它涵盖了主要的 CMR 方法、它们的优缺点，以及应用这些方法评估瓣膜疾病的最佳方式。
