Slice positioning in phase-contrast MRI impacts aortic stenosis assessment

In PC-CMR, measurements at 15mm above LAP (top left, blue line) yielded the best AVA-values in comparison to cardiac catheterization in AS-patients. AS: aortic stenosis, AVA: aortic valve area, LAP: leaflet-attachment-plane, PC-CMR: phase-contrast cardiovascular magnetic resonance imaging. (Illustra...

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Bibliographic Details
Published in:European journal of radiology 2023-04, Vol.161, p.110722-110722, Article 110722
Main Authors: Troger, Felix, Tiller, Christina, Reindl, Martin, Lechner, Ivan, Holzknecht, Magdalena, Pamminger, Mathias, Poskaite, Paulina, Kremser, Christian, Ulmer, Hanno, Gizewski, Elke Ruth, Bauer, Axel, Reinstadler, Sebastian, Metzler, Bernhard, Klug, Gert, Mayr, Agnes
Format: Article
Language:English
Subjects:
Aortic Valve - diagnostic imaging
Aortic Valve - pathology
Aortic valve stenosis
Aortic Valve Stenosis - diagnostic imaging
Aortic Valve Stenosis - pathology
Cardiac catheterization
Cardiovascular magnetic resonance imaging
Echocardiography
Humans
Magnetic Resonance Imaging
Stroke Volume
Valvular heart disease
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Summary:In PC-CMR, measurements at 15mm above LAP (top left, blue line) yielded the best AVA-values in comparison to cardiac catheterization in AS-patients. AS: aortic stenosis, AVA: aortic valve area, LAP: leaflet-attachment-plane, PC-CMR: phase-contrast cardiovascular magnetic resonance imaging. (Illustration created withhttps://biorender.com) [Display omitted] •Phase-contrast CMR is a useful tool in the diagnostic workup of aortic stenosis.•Velocity and volume measurements 0–10 mm above the valve yield a significant bias.•Measurements 10–20 mm above the valve provide reliable AVA-values.•PC-CMR measurements were in good agreement with volumetric and invasive results. To determine the phase-contrast cardiovascular magnetic resonance imaging (PC-CMR) slice-position above aortic leaflet-attachment-plane (LAP) that provides flow-velocity, –volume and aortic valve area (AVA) measurements with best agreement to invasive and echocardiographic measurements in aortic stenosis (AS). Fifty-five patients with moderate/severe AS underwent cardiac catheterization, transthoracic echocardiography (TTE) and CMR. Overall, 171 image-planes parallel to LAP were measured via PC-CMR between 22 mm below and 24 mm above LAP. AVA via PC-CMR was calculated as flow-volume divided by peak-velocity during systole. Stroke volume (SV) and AVA were compared to volumetric SV and invasive AVA via the Gorlin-formula, respectively. Above LAP, SV by PC-CMR showed no significant dependence on image-plane-position and correlated strongly with volumetry (rho: 0.633, p 
ISSN:0720-048X
1872-7727
DOI:10.1016/j.ejrad.2023.110722