Detection and quantification of valvular heart disease with dynamic cardiac MR imaging

Magnetic resonance (MR) imaging is rapidly gaining acceptance as an accurat e, reproducible, noninvasive method for optimal assessment of structural an d functional parameters in patients with valvular heart disease. The severi ty of valvular regurgitation can be evaluated with cine gradient-echo MR im aging, which allows measurement of the area of the signal void correspondin g to the abnormal flow jet. Alternatively, this modality can be used to obt ain ventricular volumetric measurements and calculate the regurgitant fract ion, or velocity-encoded cine (VEC) MR imaging can be used to quantify regu rgitant blood flow. The severity of valvular stenosis can be determined by evaluating the flow jet and associated findings with either modality or by using VEC MR imaging to calculate the transvalvular pressure gradient and v alve area. Dynamic MR imaging allows accurate assessment of ventricular fun ction and comprehensive evaluation of pathophysiologic changes. In addition , good interstudy reproducibility suggests a role for VEC NIR imaging in as sessing the effects of therapeutic intervention and monitoring regurgitant fraction, thereby helping in surgical planning and the prevention of ventri cular dysfunction. With greater cost-effectiveness and the increasing avail ability of new hardware and more advanced techniques, MR imaging will becom e a routine procedure in valvular heart disease.