Botis Ioannis, Bazmpani Maria-Anna, Daios Stylianos, Ziakas Antonios, Kamperidis Vasileios, Karamitsos Theodoros D
First Department of Cardiology, AHEPA Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece.
Diagnostics (Basel). 2024 Mar 19;14(6):644. doi: 10.3390/diagnostics14060644.
Mitral regurgitation (MR), a primary cause of valvular disease in adults, affects millions and is growing due to an ageing population. Cardiovascular magnetic resonance (CMR) has emerged as an essential tool, offering insights into valvular and myocardial pathology when compared to the primary imaging modality, echocardiography. This review highlights CMR's superiority in high-resolution volumetric assessment and tissue characterization, including also advanced techniques like late gadolinium enhancement imaging, parametric mapping, feature tracking and 4D flow analysis. These techniques provide a deeper understanding of MR's pathophysiology and its effect on cardiac chambers, enabling CMR to surpass echocardiography in predicting hard clinical outcomes and left ventricular (LV) remodelling post mitral valve surgery. Despite its advantages, CMR's application faces limitations like cost, lack of standardization, and susceptibility to arrhythmia artifacts. Nonetheless, as technological advancements continue and new evidence emerges, CMR's role in MR assessment is set to expand, offering a more nuanced and personalized approach to cardiac care. This review emphasizes the need for further research and standardized protocols to maximize CMR's potential in MR management.
二尖瓣反流（MR）是成人瓣膜性疾病的主要原因，影响着数百万人，且随着人口老龄化呈上升趋势。心血管磁共振成像（CMR）已成为一种重要工具，与主要成像方式超声心动图相比，它能深入了解瓣膜和心肌病变。本综述强调了CMR在高分辨率容积评估和组织特征分析方面的优势，其中还包括钆增强延迟成像、参数映射、特征追踪和四维血流分析等先进技术。这些技术能更深入地理解MR的病理生理学及其对心腔的影响，使CMR在预测二尖瓣手术后的严重临床结局和左心室（LV）重塑方面超越超声心动图。尽管CMR有诸多优势，但其应用仍面临成本、缺乏标准化以及易受心律失常伪影影响等限制。尽管如此，随着技术不断进步和新证据的出现，CMR在MR评估中的作用必将扩大，为心脏护理提供更细致入微和个性化的方法。本综述强调需要进一步研究并制定标准化方案，以最大限度发挥CMR在MR管理中的潜力。
