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Pype LL, Domenech-Ximenos B, Paelinck BP, Sturkenboom N, Van De Heyning CM. Assessment of Tricuspid Regurgitation by Cardiac Magnetic Resonance Imaging: Current Role and Future Applications. J Clin Med 2024; 13:4481. [PMID: 39124748 PMCID: PMC11312898 DOI: 10.3390/jcm13154481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2024] [Revised: 07/24/2024] [Accepted: 07/25/2024] [Indexed: 08/12/2024] Open
Abstract
Tricuspid regurgitation (TR) is a prevalent valvular disease with a significant mortality rate. The evaluation of TR severity and associated right heart remodeling and dysfunction is crucial to determine the optimal therapeutic strategy and to improve prognosis. While echocardiography remains the first-line imaging technique to evaluate TR, it has many limitations, both operator- and patient-related. Cardiovascular magnetic resonance imaging (CMR) has emerged as an innovative and comprehensive non-invasive cardiac imaging technique with additional value beyond routine echocardiographic assessment. Besides its established role as the gold standard for the evaluation of cardiac volumes, CMR can add important insights with regard to valvular anatomy and function. Accurate quantification of TR severity, including calculation of regurgitant volume and fraction, can be performed using either the well-known indirect volumetric method or novel 4D flow imaging. In addition, CMR can be used to assess the impact on the right heart, including right heart remodeling, function and tissue characterization. Several CMR-derived parameters have been associated with outcome, highlighting the importance of multi-modality imaging in patients with TR. The aim of this review is to provide an overview of the current role of CMR in the assessment and management of patients with TR and its future applications.
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Affiliation(s)
- Lobke L. Pype
- Department of Cardiology, University Hospital Antwerp, 2650 Edegem, Belgium; (L.L.P.)
- GENCOR Research Group, University of Antwerp, 2000 Antwerp, Belgium
| | - Blanca Domenech-Ximenos
- Department of Radiology, Hospital Clínic Barcelona, 08036 Barcelona, Spain
- Department of Cardiovascular Imaging, School of Biomedical Engineering & Imaging Sciences, King’s College London, London WC2R 2LS, UK
| | - Bernard P. Paelinck
- GENCOR Research Group, University of Antwerp, 2000 Antwerp, Belgium
- Department of Cardiac Surgery, University Hospital Antwerp, 2650 Edegem, Belgium
| | - Nicole Sturkenboom
- Department of Cardiology, University Hospital Antwerp, 2650 Edegem, Belgium; (L.L.P.)
- GENCOR Research Group, University of Antwerp, 2000 Antwerp, Belgium
| | - Caroline M. Van De Heyning
- Department of Cardiology, University Hospital Antwerp, 2650 Edegem, Belgium; (L.L.P.)
- GENCOR Research Group, University of Antwerp, 2000 Antwerp, Belgium
- Department of Cardiovascular Imaging, School of Biomedical Engineering & Imaging Sciences, King’s College London, London WC2R 2LS, UK
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Monti CB, Zanardo M, Capra D, Lastella G, Guarnieri G, Giambersio E, Pasqualin G, Sardanelli F, Secchi F. The predictive role of right ventricular late gadolinium enhancement in patients with tetralogy of Fallot undergoing pulmonary valve replacement. Eur Radiol Exp 2023; 7:9. [PMID: 36826698 PMCID: PMC9958209 DOI: 10.1186/s41747-023-00322-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 01/05/2023] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND Our purpose was to evaluate the correlations between right ventricular (RV) late gadolinium enhancement (LGE) at cardiac magnetic resonance (CMR) in patients with tetralogy of Fallot (ToF) scheduled for pulmonary valve replacement (PVR) and post-PVR functional data. METHODS We retrospectively reviewed ToF patients scheduled for PVR who underwent two CMR examinations at our institution, one before the procedure (CMR-0), including contrast-enhanced sequences, and one after the procedure (CMR-1). Functional left and RV data were obtained by segmenting short-axis stacks on both CMR examinations, and normalised variations were calculated by dividing differences between CMR-1 and CMR-0 by the intercurring time interval, whereas the RV scar burden was assessed on CMR-0 LGE sequences both semiquantitatively and quantitatively. Data were reported as median and interquartile range, differences were appraised with the Mann-Whitney U test, while correlations were assessed with Spearman's ρ. RESULTS Fifteen patients with a median age of 25 years (16-29), including 9 (60%) males, with a median time interval between CMR-0 and CMR-1 of 17 months (12-23), were retrospectively reviewed. The semiquantitative LGE score at CMR-0 was 7 (6-9), and LGE volume was 4.49 mL (3.70-5.78), covering 5.63% (4.92-7.00) of the RV. RV LGE score showed a moderate positive correlation with the normalised variation of RV stroke volume (ρ = 0.662, p = 0.007) and a borderline moderate positive correlation with the normalised variation of RV end-diastolic indexed volume (ρ = 0.513, p = 0.050). CONCLUSIONS The assessment of RV LGE before PVR may provide insights on post-PVR functional data, potentially facilitating a patient-tailored treatment pathway.
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Affiliation(s)
- Caterina Beatrice Monti
- grid.4708.b0000 0004 1757 2822Postgraduation School in Radiodiagnostics, Università degli Studi di Milano, Via Festa del Perdono 7, 20122 Milano, Italy
| | - Moreno Zanardo
- grid.4708.b0000 0004 1757 2822Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133 Milano, Italy
| | - Davide Capra
- Postgraduation School in Radiodiagnostics, Università degli Studi di Milano, Via Festa del Perdono 7, 20122, Milano, Italy.
| | - Giulia Lastella
- grid.432778.dUnit of Radiology, ASST Nord Milano, Viale Matteotti 83, 20099 Sesto San Giovanni, Italy
| | - Gianluca Guarnieri
- grid.4708.b0000 0004 1757 2822Postgraduation School in Cardiology, Università degli Studi di Milano, Via Festa del Perdono 7, 20122 Milano, Italy
| | - Emilia Giambersio
- grid.4708.b0000 0004 1757 2822Postgraduation School in Radiodiagnostics, Università degli Studi di Milano, Via Festa del Perdono 7, 20122 Milano, Italy
| | - Giulia Pasqualin
- grid.419557.b0000 0004 1766 7370Pediatric and Adult Congenital Heart Centre, IRCCS Policlinico San Donato, Via Morandi 30, 20097 San Donato Milanese, Italy
| | - Francesco Sardanelli
- grid.4708.b0000 0004 1757 2822Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133 Milano, Italy ,grid.419557.b0000 0004 1766 7370Department of Radiology, IRCCS Policlinico San Donato, Via Morandi 30, 20097 San Donato Milanese, Italy
| | - Francesco Secchi
- grid.4708.b0000 0004 1757 2822Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133 Milano, Italy ,grid.419557.b0000 0004 1766 7370Department of Radiology, IRCCS Policlinico San Donato, Via Morandi 30, 20097 San Donato Milanese, Italy
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Costantini P, Perone F, Siani A, Groenhoff L, Muscogiuri G, Sironi S, Marra P, Carriero S, Pavon AG, Guglielmo M. Multimodality Imaging of the Neglected Valve: Role of Echocardiography, Cardiac Magnetic Resonance and Cardiac Computed Tomography in Pulmonary Stenosis and Regurgitation. J Imaging 2022; 8:278. [PMID: 36286372 PMCID: PMC9605303 DOI: 10.3390/jimaging8100278] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 09/25/2022] [Accepted: 10/05/2022] [Indexed: 11/17/2022] Open
Abstract
The pulmonary valve (PV) is the least imaged among the heart valves. However, pulmonary regurgitation (PR) and pulmonary stenosis (PS) can occur in a variety of patients ranging from fetuses, newborns (e.g., tetralogy of Fallot) to adults (e.g., endocarditis, carcinoid syndrome, complications of operated tetralogy of Fallot). Due to their complexity, PR and PS are studied using multimodality imaging to assess their mechanism, severity, and hemodynamic consequences. Multimodality imaging is crucial to plan the correct management and to follow up patients with pulmonary valvulopathy. Echocardiography remains the first line methodology to assess patients with PR and PS, but the information obtained with this technique are often integrated with cardiac magnetic resonance (CMR) and computed tomography (CT). This state-of-the-art review aims to provide an updated overview of the usefulness, strengths, and limits of multimodality imaging in patients with PR and PS.
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Affiliation(s)
- Pietro Costantini
- Radiology Department, Ospedale Maggiore della Carità University Hospital, 28100 Novara, Italy
| | - Francesco Perone
- Cardiac Rehabilitation Unit, Rehabilitation Clinic “Villa delle Magnolie”, 81020 Castel Morrone, Italy
| | - Agnese Siani
- Radiology Department, Ospedale Maggiore della Carità University Hospital, 28100 Novara, Italy
| | - Léon Groenhoff
- Radiology Department, Ospedale Maggiore della Carità University Hospital, 28100 Novara, Italy
| | - Giuseppe Muscogiuri
- School of Medicine and Surgery, University of Milano-Bicocca, 20126 Milan, Italy
- Department of Radiology, Istituto Auxologico Italiano, IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico), San Luca Hospital, 20149 Milan, Italy
| | - Sandro Sironi
- School of Medicine and Surgery, University of Milano-Bicocca, 20126 Milan, Italy
- Department of Radiology, ASST Papa Giovanni XXIII Hospital, 24129 Bergamo, Italy
| | - Paolo Marra
- School of Medicine and Surgery, University of Milano-Bicocca, 20126 Milan, Italy
- Department of Radiology, ASST Papa Giovanni XXIII Hospital, 24129 Bergamo, Italy
| | - Serena Carriero
- Postgraduate School in Radiodiagnostics, Università degli Studi di Milano, 20133 Milan, Italy
| | - Anna Giulia Pavon
- Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, 6900 Lugano, Switzerland
| | - Marco Guglielmo
- Department of Cardiology, Division of Heart and Lungs, Utrecht University Medical Center, Utrecht University, 3584CX Utrecht, The Netherlands
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Nishigake D, Yamasaki Y, Yamamura K, Funatsu R, Wada T, Oga M, Kobayashi K, Kato T, Ishigami K. High-resolution systolic T1 mapping with compressed sensing for the evaluation of the right ventricle: a phantom and volunteer study. THE INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING 2022; 38:2219-2225. [PMID: 37726459 DOI: 10.1007/s10554-022-02622-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 04/12/2022] [Indexed: 11/28/2022]
Abstract
To investigate the usefulness of high-resolution systolic T1 mapping using compressed sensing for right ventricular (RV) evaluation. Phantoms and normal volunteers were scanned at 3 T by using a high-resolution (HR) modified look-locker inversion recovery (MOLLI) pulse sequence and a conventional MOLLI pulse sequence. The T1 values of the left ventricular (LV) and RV myocardium and blood pool were measured for each sequence. T1 values of HR-MOLLI and MOLLI sequences were compared in the LV myocardium, blood pool, and RV myocardium. The T1 values of HR-MOLLI and MOLLI showed good agreement in both phantoms and the LV myocardium and blood pool of volunteers. However, there was a significant difference between HR-MOLLI and MOLLI in the RV myocardium (1258 ± 52 ms vs. 1327 ± 73 ms; P = 0.0005). No significant difference was observed between the T1 value of RV and that of LV (1217 ± 32 ms) in HR-MOLLI, whereas the T1 value of RV was significantly higher than that of LV in MOLLI (P < 0.0001). The interclass correlation coefficients of intraobserver variabilities from HR-MOLLI and MOLLI were 0.919 and 0.804, respectively, and the interobserver variabilities from HR-MOLLI and MOLLI were 0.838 and 0.848, respectively. Assessment of RV myocardium by using HR systolic T1 mapping was superior to the conventional MOLLI sequence in terms of accuracy and reproducibility.
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Affiliation(s)
- Daisuke Nishigake
- Division of Radiology, Department of Medical Technology, Kyushu University Hospital, Fukuoka, Japan
| | - Yuzo Yamasaki
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - Kenichiro Yamamura
- Department of Perinatal and Pediatric Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Ryohei Funatsu
- Division of Radiology, Department of Medical Technology, Kyushu University Hospital, Fukuoka, Japan
| | - Tatsuhiro Wada
- Division of Radiology, Department of Medical Technology, Kyushu University Hospital, Fukuoka, Japan
| | - Masahiro Oga
- Division of Radiology, Department of Medical Technology, Kyushu University Hospital, Fukuoka, Japan
| | - Koji Kobayashi
- Division of Radiology, Department of Medical Technology, Kyushu University Hospital, Fukuoka, Japan
| | - Toyoyuki Kato
- Division of Radiology, Department of Medical Technology, Kyushu University Hospital, Fukuoka, Japan
| | - Kousei Ishigami
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Alfarih M, Augusto JB, Knott KD, Fatih N, Kumar MP, Boubertakh R, Hughes AD, Moon JC, Weingärtner S, Captur G. Saturation-pulse prepared heart-rate independent inversion-recovery (SAPPHIRE) biventricular T1 mapping: inter-field strength, head-to-head comparison of diastolic, systolic and dark-blood measurements. BMC Med Imaging 2022; 22:122. [PMID: 35799139 PMCID: PMC9264718 DOI: 10.1186/s12880-022-00843-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 06/24/2022] [Indexed: 11/17/2022] Open
Abstract
Background To assess the feasibility of biventricular SAPPHIRE T1 mapping in vivo across field strengths using diastolic, systolic and dark-blood (DB) approaches. Methods 10 healthy volunteers underwent same-day non-contrast cardiovascular magnetic resonance at 1.5 Tesla (T) and 3 T. Left and right ventricular (LV, RV) T1 mapping was performed in the basal, mid and apical short axis using 4-variants of SAPPHIRE: diastolic, systolic, 0th and 2nd order motion-sensitized DB and conventional modified Look-Locker inversion recovery (MOLLI). Results LV global myocardial T1 times (1.5 T then 3 T results) were significantly longer by diastolic SAPPHIRE (1283 ± 11|1600 ± 17 ms) than any of the other SAPPHIRE variants: systolic (1239 ± 9|1595 ± 13 ms), 0th order DB (1241 ± 10|1596 ± 12) and 2nd order DB (1251 ± 11|1560 ± 20 ms, all p < 0.05). In the mid septum MOLLI and diastolic SAPPHIRE exhibited significant T1 signal contamination (longer T1) at the blood-myocardial interface not seen with the other 3 SAPPHIRE variants (all p < 0.025). Additionally, systolic, 0th order and 2nd order DB SAPPHIRE showed narrower dispersion of myocardial T1 times across the mid septum when compared to diastolic SAPPHIRE (interquartile ranges respectively: 25 ms, 71 ms, 73 ms vs 143 ms, all p < 0.05). RV T1 mapping was achievable using systolic, 0th and 2nd order DB SAPPHIRE but not with MOLLI or diastolic SAPPHIRE. All 4 SAPPHIRE variants showed excellent re-read reproducibility (intraclass correlation coefficients 0.953 to 0.996). Conclusion These small-scale preliminary healthy volunteer data suggest that DB SAPPHIRE has the potential to reduce partial volume effects at the blood-myocardial interface, and that systolic SAPPHIRE could be a feasible solution for right ventricular T1 mapping. Further work is needed to understand the robustness of these sequences and their potential clinical utility. Supplementary Information The online version contains supplementary material available at 10.1186/s12880-022-00843-0.
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Affiliation(s)
- Mashael Alfarih
- Barts Heart Center, The Cardiovascular Magnetic Resonance Imaging Unit, St Bartholomew's Hospital, West Smithfield, London, EC1A 7BE, UK.,Institute of Cardiovascular Science, University College London, Gower Street, London, WC1E 6BT, UK.,Department of Cardiac Technology, College of Applied Medial Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - João B Augusto
- Barts Heart Center, The Cardiovascular Magnetic Resonance Imaging Unit, St Bartholomew's Hospital, West Smithfield, London, EC1A 7BE, UK.,Institute of Cardiovascular Science, University College London, Gower Street, London, WC1E 6BT, UK
| | - Kristopher D Knott
- Institute of Cardiovascular Science, University College London, Gower Street, London, WC1E 6BT, UK
| | - Nasri Fatih
- Institute of Cardiovascular Science, University College London, Gower Street, London, WC1E 6BT, UK
| | - M Praveen Kumar
- Department of Pharmacology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Redha Boubertakh
- William Harvey Research Institute, Queen Mary University of London, Charterhouse Square, London, UK
| | - Alun D Hughes
- Institute of Cardiovascular Science, University College London, Gower Street, London, WC1E 6BT, UK.,UCL MRC Unit for Lifelong Health and Ageing, 33 Bedford Place, London, WC1B 5JU, UK
| | - James C Moon
- Barts Heart Center, The Cardiovascular Magnetic Resonance Imaging Unit, St Bartholomew's Hospital, West Smithfield, London, EC1A 7BE, UK.,Institute of Cardiovascular Science, University College London, Gower Street, London, WC1E 6BT, UK
| | - Sebastian Weingärtner
- Electrical and Computer Engineering, University of Minnesota, Minneapolis, MN, USA.,Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands
| | - Gabriella Captur
- Barts Heart Center, The Cardiovascular Magnetic Resonance Imaging Unit, St Bartholomew's Hospital, West Smithfield, London, EC1A 7BE, UK. .,Institute of Cardiovascular Science, University College London, Gower Street, London, WC1E 6BT, UK. .,UCL MRC Unit for Lifelong Health and Ageing, 33 Bedford Place, London, WC1B 5JU, UK. .,Cardiology Department, Royal Free Hospital NHS Trust, Pond St, Hampstead, London, NW3 2QG, UK.
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