Cardiology, Norfolk and Norwich University Hospital NHS Trust, Norwich, UK.
Norwich Medical School, University of East Anglia, Norwich, NR4 7TJ, UK.
J Med Case Rep. 2022 May 16;16(1):205. doi: 10.1186/s13256-022-03422-7.
Doppler transthoracic echocardiography is routinely performed to measure peak mitral inflow velocities in the assessment of left ventricular diastolic function. The limitations of echocardiography are well documented, but its accuracy in the measurement of transmitral peak velocity in the presence of aortic valve regurgitation has not yet been compared with four-dimensional flow cardiac magnetic resonance imaging. Four-dimensional flow cardiac magnetic resonance imaging offers time-resolved cross-sectional velocity information that can be used to investigate mitral inflow peak velocity. We present a case report demonstrating the potential superior capabilities of four-dimensional flow cardiac magnetic resonance imaging in accurately detecting mitral inflow velocities over Doppler echocardiography in patients with aortic regurgitation.
A 67-year-old Caucasian female presented to our outpatient cardiology clinic with exertional dyspnea. Doppler transthoracic echocardiography identified moderate to severe aortic regurgitation. Mapping of mitral inflow peak velocities proved challenging with Doppler echocardiography. Additionally, four-dimensional flow cardiac magnetic resonance imaging with automated three-dimensional flow streamlines was performed, which allowed for more accurate detection of mitral inflow peak velocities.
Doppler echocardiography has a limited role in mitral inflow assessment where aortic regurgitation is present. In such cases, four-dimensional flow cardiac magnetic resonance imaging is an alternative imaging technique that may circumvent this issue and allow mitral inflow assessment.
多普勒经胸超声心动图常用于评估左心室舒张功能，以测量二尖瓣口血流峰值速度。超声心动图的局限性已得到充分证实，但在主动脉瓣反流的情况下，其测量二尖瓣口峰值速度的准确性尚未与四维血流心脏磁共振成像进行比较。四维血流心脏磁共振成像提供了时间分辨的截面速度信息，可用于研究二尖瓣口血流峰值速度。我们报告了一例病例，该病例显示了在主动脉瓣反流患者中，四维血流心脏磁共振成像在准确检测二尖瓣口血流速度方面具有优于多普勒超声心动图的潜在能力。
一名 67 岁的白人女性因劳力性呼吸困难到我们的门诊心内科就诊。多普勒经胸超声心动图发现中度至重度主动脉瓣反流。用多普勒超声心动图对二尖瓣口血流峰值速度进行定位具有挑战性。此外，还进行了四维血流心脏磁共振成像和自动三维血流流线分析，这使得更准确地检测二尖瓣口血流峰值速度成为可能。
在存在主动脉瓣反流的情况下，多普勒超声心动图在二尖瓣口血流评估中的作用有限。在这种情况下，四维血流心脏磁共振成像作为一种替代成像技术，可能会规避这一问题，并允许进行二尖瓣口血流评估。
