MR imaging of acquired heart disease.

Spin echo and gradient reversal MR imaging techniques provide a noninvasive means of analyzing the state of ventricular myocardium in patients with atherosclerotic and valvular heart disease. Local ischemic changes are manifested on spin echo MR examination as loci of increased signal intensity, most likely representing accumulation of local myocardial edema. Administration of intravenous paramagnetic contrast material further enhances local changes, increasing the sensitivity of MR methods for detecting such change. Application of spin echo and gradient reversal techniques also provides direct demonstration of morphologic changes in chamber volume and myocardial wall thickness and thickening, the sequelae of ischemic and acquired valvular heart disease, as well as direct demonstration of abnormal blood flow across diseased valves. Newer methods of analysis of these flow abnormalities provide information concerning pressure gradients across stenotic valves and regurgitant fractions across insufficient valves. Thus, application of MR imaging techniques provides clinically relevant information needed by referring clinicians for the management of patients with acquired heart disease.