Guglielmo Marco, Rovera Chiara, Rabbat Mark G, Pontone Gianluca
Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy.
Division of Cardiology, Loyola University of Chicago, Chicago, IL 60611, USA.
J Cardiovasc Dev Dis. 2022 Apr 4;9(4):108. doi: 10.3390/jcdd9040108.
Cardiac magnetic resonance (CMR) imaging is a well-set diagnostic technique for assessment of valvular heart diseases and is gaining ground in current clinical practice. It provides high-quality images without the administration of ionizing radiation and occasionally without the need of contrast agents. It offers the unique possibility of a comprehensive stand-alone assessment of the heart including biventricular function, left ventricle remodeling, myocardial fibrosis, and associated valvulopathies. CMR is the recognized reference for the quantification of ventricular volumes, mass, and function. A particular strength is the ability to quantify flow, especially with new techniques which allow accurate measurement of stenosis and regurgitation. Furthermore, tissue mapping enables the visualization and quantification of structural changes in the myocardium. In this way, CMR has the potential to yield important prognostic information predicting those patients who will progress to surgery and impact outcomes. In this review, the fundamentals of CMR in assessment of aortic valve diseases (AVD) are described, together with its strengths and weaknesses. This state-of-the-art review provides an updated overview of CMR potentials in all AVD issues, including valve anatomy, flow quantification, ventricular volumes and function, and tissue characterization.
心脏磁共振(CMR)成像对于评估心脏瓣膜病是一种成熟的诊断技术,并且在当前临床实践中越来越受到重视。它无需电离辐射即可提供高质量图像,偶尔也无需使用造影剂。它提供了对心脏进行全面独立评估的独特可能性,包括双心室功能、左心室重塑、心肌纤维化以及相关瓣膜病变。CMR是公认的心室容积、质量和功能量化的参考标准。其一个特别优势是能够量化血流,尤其是采用允许精确测量狭窄和反流的新技术时。此外,组织成像能够实现心肌结构变化的可视化和量化。通过这种方式,CMR有潜力产生重要的预后信息,预测哪些患者将进展至手术并影响预后。在本综述中,将描述CMR评估主动脉瓣疾病(AVD)的基本原理及其优缺点。这篇前沿综述提供了CMR在所有AVD问题方面潜力的最新概述,包括瓣膜解剖、血流量化、心室容积和功能以及组织特征。