Aortic stenosis MRI

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-In-Chief: Claudia P. Hochberg, M.D. [2], Abdul-Rahman Arabi, M.D. [3], Keri Shafer, M.D. [4], Priyamvada Singh, MBBS [5]; Assistant Editor-In-Chief: Kristin Feeney, B.S. [6]

Overview

Magnetic resonance imaging can be helpful as a diagnostic tool in conditions where the echocardiographic findings are inconclusive.

Magnetic Resonance Imaging

Magnetic resonance imaging (MRI) can be used as a diagnostic modality in aortic stenosis.

Advantages of using MRI include:

• It can be used in cases where echocardiographic results are inconclusive.
• Helps in measuring heart volumes, blood flow and ventricular wall thickness.
• The magnetic resonance angiography helps in better visualization of heart vasculature.
• Phase velocity mapping helps in measuring the ratio of pulmonary to systemic blood flow (Qp:Qs).

For successful MRI procedure breath holding is required, which is sometimes difficult to achieve with small kids. Due to this, the procedure is done under general anesthesia in children.

Cardiovascular MRI (CMR) is a useful tool in diagnosis and evaluation of bicuspid aortic valve. Stead-state free precession sequences are used to obtain a slice in the place of the valve, and show the anatomy of the valve well. Differentiation may be made between an anatomically bicuspid valve, and anatomically trileaflet valve with fused comissures ("functionally-bicuspid valve"). In addition, CMR is invaluable in defining anatomic valve area, in quantification of aortic regurgitation, and in diagnosis of concomitant cardiovascular abnormalities, such as thoracic aortic dilatation/aneurysm and mitral valve abnormalities.