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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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| Published in: | European journal of radiology 2023-04, Vol.161, p.110722-110722, Article 110722 |
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| container_title | European journal of radiology |
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| creator | 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 |
| description | 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 |
| doi_str_mv | 10.1016/j.ejrad.2023.110722 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2775613472</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0720048X23000360</els_id><sourcerecordid>2775613472</sourcerecordid><originalsourceid>FETCH-LOGICAL-c359t-37b141f197b5052235ced153ba21f61ed8416855ab0b46f077795a723ac9100e3</originalsourceid><addsrcrecordid>eNp9kElLxEAQhRtRnHH0FwiSo5eMvaTTycGDDC4jiuAC3ppOp6IdstnVI_jvzTijR09FFe_V432EHDM6Z5SlZ_Ucam_KOadczBmjivMdMmWZ4rFSXO2S6XiiMU2y1wk5QKwppTLJ-T6ZiFTJjKtsSm6fGmchGnp0wfWd694i10XDu0GIbd8FbzBE94_LyLWDsQEj0_vgbIQButEz7oiA2EIXDsleZRqEo-2ckZery-fFTXz3cL1cXNzFVsg8xEIVLGEVy1UhqeRcSAslk6IwnFUpgzJLWJpJaQpaJGlFlVK5NIoLY3NGKYgZOd38HXz_sQIMunVooWlMB_0KNVdKpkwko2VGxEZqfY_oodKDd63xX5pRvYaoa_0DUa8h6g3E0XWyDVgVLZR_nl9qo-B8I4Cx5qcDr9E66MYezoMNuuzdvwHfjdKC6g</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2775613472</pqid></control><display><type>article</type><title>Slice positioning in phase-contrast MRI impacts aortic stenosis assessment</title><source>ScienceDirect Freedom Collection 2022-2024</source><creator>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</creator><creatorcontrib>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</creatorcontrib><description>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 < 0.001, marginal-mean-difference (MMD): 1 ml, 95 % confidence-interval (CI): −4 to 6). AVA assessed in image-planes 0–10 mm above LAP differed significantly from invasive measurement (MMD: −0.14 cm2, 95 %CI: 0.08–0.21). In contrast, AVA-values by PC-CMR measured 10–20 mm above LAP showed good agreement with invasive determination without significant MMD (0.003 cm2, 95 %CI: −0.09 to 0.09). Within these measurements, a plane 15 mm above LAP resulted in the lowest bias (MMD: 0.02 cm2, 95 %CI:-0.29 to 0.33). SV and AVA via TTE correlated moderately with volumetry (rho: 0.461, p < 0.001; bias: 15 ml, p < 0.001) and cardiac catheterization (rho: 0.486, p < 0.001, bias: −0.13 cm2, p < 0.001), respectively.
PC-CMR measurements at 0–10 mm above LAP should be avoided due to significant AVA-overestimation compared to invasive determination. AVA-assessment by PC-CMR between 10 and 20 mm above LAP did not differ from invasive measurements, with the lowest intermethodical bias measured 15 mm above LAP.</description><identifier>ISSN: 0720-048X</identifier><identifier>EISSN: 1872-7727</identifier><identifier>DOI: 10.1016/j.ejrad.2023.110722</identifier><identifier>PMID: 36758278</identifier><language>eng</language><publisher>Ireland: Elsevier B.V</publisher><subject>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</subject><ispartof>European journal of radiology, 2023-04, Vol.161, p.110722-110722, Article 110722</ispartof><rights>2023</rights><rights>Copyright © 2023. Published by Elsevier B.V.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c359t-37b141f197b5052235ced153ba21f61ed8416855ab0b46f077795a723ac9100e3</citedby><cites>FETCH-LOGICAL-c359t-37b141f197b5052235ced153ba21f61ed8416855ab0b46f077795a723ac9100e3</cites><orcidid>0000-0001-9363-873X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36758278$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Troger, Felix</creatorcontrib><creatorcontrib>Tiller, Christina</creatorcontrib><creatorcontrib>Reindl, Martin</creatorcontrib><creatorcontrib>Lechner, Ivan</creatorcontrib><creatorcontrib>Holzknecht, Magdalena</creatorcontrib><creatorcontrib>Pamminger, Mathias</creatorcontrib><creatorcontrib>Poskaite, Paulina</creatorcontrib><creatorcontrib>Kremser, Christian</creatorcontrib><creatorcontrib>Ulmer, Hanno</creatorcontrib><creatorcontrib>Gizewski, Elke Ruth</creatorcontrib><creatorcontrib>Bauer, Axel</creatorcontrib><creatorcontrib>Reinstadler, Sebastian</creatorcontrib><creatorcontrib>Metzler, Bernhard</creatorcontrib><creatorcontrib>Klug, Gert</creatorcontrib><creatorcontrib>Mayr, Agnes</creatorcontrib><title>Slice positioning in phase-contrast MRI impacts aortic stenosis assessment</title><title>European journal of radiology</title><addtitle>Eur J Radiol</addtitle><description>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 < 0.001, marginal-mean-difference (MMD): 1 ml, 95 % confidence-interval (CI): −4 to 6). AVA assessed in image-planes 0–10 mm above LAP differed significantly from invasive measurement (MMD: −0.14 cm2, 95 %CI: 0.08–0.21). In contrast, AVA-values by PC-CMR measured 10–20 mm above LAP showed good agreement with invasive determination without significant MMD (0.003 cm2, 95 %CI: −0.09 to 0.09). Within these measurements, a plane 15 mm above LAP resulted in the lowest bias (MMD: 0.02 cm2, 95 %CI:-0.29 to 0.33). SV and AVA via TTE correlated moderately with volumetry (rho: 0.461, p < 0.001; bias: 15 ml, p < 0.001) and cardiac catheterization (rho: 0.486, p < 0.001, bias: −0.13 cm2, p < 0.001), respectively.
PC-CMR measurements at 0–10 mm above LAP should be avoided due to significant AVA-overestimation compared to invasive determination. AVA-assessment by PC-CMR between 10 and 20 mm above LAP did not differ from invasive measurements, with the lowest intermethodical bias measured 15 mm above LAP.</description><subject>Aortic Valve - diagnostic imaging</subject><subject>Aortic Valve - pathology</subject><subject>Aortic valve stenosis</subject><subject>Aortic Valve Stenosis - diagnostic imaging</subject><subject>Aortic Valve Stenosis - pathology</subject><subject>Cardiac catheterization</subject><subject>Cardiovascular magnetic resonance imaging</subject><subject>Echocardiography</subject><subject>Humans</subject><subject>Magnetic Resonance Imaging</subject><subject>Stroke Volume</subject><subject>Valvular heart disease</subject><issn>0720-048X</issn><issn>1872-7727</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNp9kElLxEAQhRtRnHH0FwiSo5eMvaTTycGDDC4jiuAC3ppOp6IdstnVI_jvzTijR09FFe_V432EHDM6Z5SlZ_Ucam_KOadczBmjivMdMmWZ4rFSXO2S6XiiMU2y1wk5QKwppTLJ-T6ZiFTJjKtsSm6fGmchGnp0wfWd694i10XDu0GIbd8FbzBE94_LyLWDsQEj0_vgbIQButEz7oiA2EIXDsleZRqEo-2ckZery-fFTXz3cL1cXNzFVsg8xEIVLGEVy1UhqeRcSAslk6IwnFUpgzJLWJpJaQpaJGlFlVK5NIoLY3NGKYgZOd38HXz_sQIMunVooWlMB_0KNVdKpkwko2VGxEZqfY_oodKDd63xX5pRvYaoa_0DUa8h6g3E0XWyDVgVLZR_nl9qo-B8I4Cx5qcDr9E66MYezoMNuuzdvwHfjdKC6g</recordid><startdate>202304</startdate><enddate>202304</enddate><creator>Troger, Felix</creator><creator>Tiller, Christina</creator><creator>Reindl, Martin</creator><creator>Lechner, Ivan</creator><creator>Holzknecht, Magdalena</creator><creator>Pamminger, Mathias</creator><creator>Poskaite, Paulina</creator><creator>Kremser, Christian</creator><creator>Ulmer, Hanno</creator><creator>Gizewski, Elke Ruth</creator><creator>Bauer, Axel</creator><creator>Reinstadler, Sebastian</creator><creator>Metzler, Bernhard</creator><creator>Klug, Gert</creator><creator>Mayr, Agnes</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-9363-873X</orcidid></search><sort><creationdate>202304</creationdate><title>Slice positioning in phase-contrast MRI impacts aortic stenosis assessment</title><author>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</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c359t-37b141f197b5052235ced153ba21f61ed8416855ab0b46f077795a723ac9100e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Aortic Valve - diagnostic imaging</topic><topic>Aortic Valve - pathology</topic><topic>Aortic valve stenosis</topic><topic>Aortic Valve Stenosis - diagnostic imaging</topic><topic>Aortic Valve Stenosis - pathology</topic><topic>Cardiac catheterization</topic><topic>Cardiovascular magnetic resonance imaging</topic><topic>Echocardiography</topic><topic>Humans</topic><topic>Magnetic Resonance Imaging</topic><topic>Stroke Volume</topic><topic>Valvular heart disease</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Troger, Felix</creatorcontrib><creatorcontrib>Tiller, Christina</creatorcontrib><creatorcontrib>Reindl, Martin</creatorcontrib><creatorcontrib>Lechner, Ivan</creatorcontrib><creatorcontrib>Holzknecht, Magdalena</creatorcontrib><creatorcontrib>Pamminger, Mathias</creatorcontrib><creatorcontrib>Poskaite, Paulina</creatorcontrib><creatorcontrib>Kremser, Christian</creatorcontrib><creatorcontrib>Ulmer, Hanno</creatorcontrib><creatorcontrib>Gizewski, Elke Ruth</creatorcontrib><creatorcontrib>Bauer, Axel</creatorcontrib><creatorcontrib>Reinstadler, Sebastian</creatorcontrib><creatorcontrib>Metzler, Bernhard</creatorcontrib><creatorcontrib>Klug, Gert</creatorcontrib><creatorcontrib>Mayr, Agnes</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Troger, Felix</au><au>Tiller, Christina</au><au>Reindl, Martin</au><au>Lechner, Ivan</au><au>Holzknecht, Magdalena</au><au>Pamminger, Mathias</au><au>Poskaite, Paulina</au><au>Kremser, Christian</au><au>Ulmer, Hanno</au><au>Gizewski, Elke Ruth</au><au>Bauer, Axel</au><au>Reinstadler, Sebastian</au><au>Metzler, Bernhard</au><au>Klug, Gert</au><au>Mayr, Agnes</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Slice positioning in phase-contrast MRI impacts aortic stenosis assessment</atitle><jtitle>European journal of radiology</jtitle><addtitle>Eur J Radiol</addtitle><date>2023-04</date><risdate>2023</risdate><volume>161</volume><spage>110722</spage><epage>110722</epage><pages>110722-110722</pages><artnum>110722</artnum><issn>0720-048X</issn><eissn>1872-7727</eissn><abstract>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 < 0.001, marginal-mean-difference (MMD): 1 ml, 95 % confidence-interval (CI): −4 to 6). AVA assessed in image-planes 0–10 mm above LAP differed significantly from invasive measurement (MMD: −0.14 cm2, 95 %CI: 0.08–0.21). In contrast, AVA-values by PC-CMR measured 10–20 mm above LAP showed good agreement with invasive determination without significant MMD (0.003 cm2, 95 %CI: −0.09 to 0.09). Within these measurements, a plane 15 mm above LAP resulted in the lowest bias (MMD: 0.02 cm2, 95 %CI:-0.29 to 0.33). SV and AVA via TTE correlated moderately with volumetry (rho: 0.461, p < 0.001; bias: 15 ml, p < 0.001) and cardiac catheterization (rho: 0.486, p < 0.001, bias: −0.13 cm2, p < 0.001), respectively.
PC-CMR measurements at 0–10 mm above LAP should be avoided due to significant AVA-overestimation compared to invasive determination. AVA-assessment by PC-CMR between 10 and 20 mm above LAP did not differ from invasive measurements, with the lowest intermethodical bias measured 15 mm above LAP.</abstract><cop>Ireland</cop><pub>Elsevier B.V</pub><pmid>36758278</pmid><doi>10.1016/j.ejrad.2023.110722</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0001-9363-873X</orcidid></addata></record> |
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| ispartof | European journal of radiology, 2023-04, Vol.161, p.110722-110722, Article 110722 |
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| source | ScienceDirect Freedom Collection 2022-2024 |
| 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 |
| title | Slice positioning in phase-contrast MRI impacts aortic stenosis assessment |
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