Ambrosi P, Habib G, Ferracci A, Faugère G, Luccioni R, Bernard P J
Service de cardiologie et d'hématologie isotopiques, hôpital de la Timone, Marseille.
Arch Mal Coeur Vaiss. 1997 Nov;90(11):1463-7.
Cine-MRI demonstrates the presence of mitral regurgitation by a signal void. This study was undertaken to assess the value of this method for quantification of mitral regurgitation in a population not excluding either patients with mitral valve prostheses or those with atrial fibrillation. The subjects included had a mean age of 59 years and were referred for transoesophageal echocardiography, either for assessment of valvular heart disease (38 patients), or for detection of atrial thrombosis before external electrical cardioversion (7 patients). Eight patients had mitral valve prostheses and 19 were in atrial fibrillation. Cine-MRI was performed within 12 days of the transoesophageal echocardiography study with a 1.5 tesla magnet, using a sequence of gradient echo in 3 parallel planes in the 4 chamber view. The regurgitation was quantified by MRI from the extension of the signal void in the left atrium. The transoesophageal Doppler echocardiographic criteria were the width of the regurgitant jet at its origin, the intensity of the regurgitation signal recorded by continuous wave Doppler and the extension of the jet within the left atrium. The quantification by degrees 1 to 4 did not differ by more than 1 degree between the 2 techniques in 43 of the 45 patients. Out of 4 left atrial thrombus detected by transoesophageal echocardiography, only 1 was visible by MRI. The authors concluded that quantification of mitral regurgitation by cine-MRI provides similar results to those obtained by transoesophageal echocardiography and that the correlation remains valid in cases of atrial fibrillation. However, Doppler echocardiography provides further valuable information for the clinician.
电影磁共振成像(Cine-MRI)通过信号缺失显示二尖瓣反流的存在。本研究旨在评估该方法在不排除二尖瓣人工瓣膜患者或心房颤动患者的人群中对二尖瓣反流进行定量分析的价值。纳入的受试者平均年龄为59岁,因评估瓣膜性心脏病(38例患者)或在体外电复律前检测心房血栓形成(7例患者)而接受经食管超声心动图检查。8例患者有二尖瓣人工瓣膜,19例处于心房颤动状态。在经食管超声心动图检查后的12天内,使用1.5特斯拉磁体进行电影磁共振成像,在四腔心视图的3个平行平面上采用梯度回波序列。通过左心房信号缺失的范围,利用磁共振成像对反流进行定量分析。经食管多普勒超声心动图标准为反流束起始处的宽度、连续波多普勒记录的反流信号强度以及反流束在左心房内的范围。在45例患者中的43例中,两种技术对反流程度1至4级的定量分析差异不超过1级。在经食管超声心动图检测出的4例左心房血栓中,磁共振成像仅能显示1例。作者得出结论,电影磁共振成像对二尖瓣反流的定量分析结果与经食管超声心动图相似,且在心房颤动病例中相关性仍然有效。然而,多普勒超声心动图为临床医生提供了更多有价值的信息。