DYNAMIC MAGNETIC-RESONANCE-IMAGING OF AOR TIC REGURGITATION - COMPARISON WITH CONTRAST AORTOGRAPHY AND COLOR DOPPLER-ECHOCARDIOGRAPHY

To evaluate the usefulness of cine-MRI for the quantitative assessment of aortic valve regurgitation, 31 patients (54 +/- 15 years of age; 2 2 M, 9 F) and 10 normal volunteers underwent a multi-modality imaging protocol comparing cine-MRI with color Doppler echocardiography and co ntrast aortography. Twenty-one patients had aortic regurgitation with an associated transvalvular gradient, 10 patients had pure valve incom petence. Aortic insufficiency as assessed by the signal void from regu rgitant flow on cine-MRI was best analyzed on transversal tomograms. B oth the volume of the signal void caused by turbulance above a thresho ld velocity, and the ratio of the diameters of the regurgitant jet and the outflow tract (d(Al-Jet)/D(LVOT)) were found to correlate closely with the (Seller's) angiographic regurgitant score by r = 0.86 each ( p < 0.001), and the color Doppler echocardiographic index by r = 0.74 and 0.89, respectively (p < 0.001). Cine-MRI failed to differentiate t he angiographic grades I and II, however, clearly separated grades II, III, and IV in contrast to other non-invasive imaging modalities. Mor eover, a semiquantitative index derived from cine-MRI allowed a rapid assessment of the severity of regurgitation, similar to color Doppler echocardiography and the semiquantitative angiographic Seller's score. Thus, cine-MRI volumetric evaluation of transvalvular flow turbulance s provides a useful and reproducible means to quantify aortic regurgit ation. It also allows serial atraumatic investigations as a diagnostic alternative to color Doppler examination in patients less suitable fo r echocardiographic evaluation and may prove helpful in monitoring the natural course of aortic valve disease.