Heart valve disease: investigation by cardiovascular magnetic resonance.
Heart valve disease: investigation by cardiovascular magnetic resonance.
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DOI：
10.1186/1532-429x-14-7
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发表时间：
2012-01-19
期刊：
影响因子：
--
通讯作者：
Myerson SG
中科院分区：
文献类型：
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作者：
Myerson SG
心血管磁共振（CMR）已成为心脏医学许多领域的宝贵研究工具。然而，其在心脏瓣膜疾病中的价值尚未得到充分认识，特别是因为超声心动图是治疗瓣膜疾病的一种强大且广泛使用的技术。这篇综述强调了 CMR 可以在瓣膜疾病中带来的附加价值，在许多领域补充超声心动图，但它也已成为某些领域的一线检查，例如肺动脉瓣疾病和评估右心室。 CMR 具有许多优点，包括能够在任何平面上成像，从而可以完全可视化瓣膜及其流入/流出道、直接测量瓣膜面积（特别是狭窄瓣膜）以及相关大血管解剖结构的表征（例如主动脉瓣疾病中的主动脉根和弓）。一个特殊的优势是能够量化流量，从而可以准确测量反流、心脏分流量/比率和差流量（例如左肺动脉和右肺动脉）。心室体积和质量的量化对于确定瓣膜疾病对心脏的影响至关重要，而 CMR 是这方面的“黄金标准”。该技术的局限性包括由于图像切片厚度导致的部分体积效应，以及由于需要在多个心动周期内采集图像而识别小型、高度移动的物体（例如植被）的能力较低。该综述详细检查了每个成像方面的优点和缺点，并考虑了如何针对每个瓣膜病变最佳地使用 CMR。
Cardiovascular magnetic resonance (CMR) has become a valuable investigative tool in many areas of cardiac medicine. Its value in heart valve disease is less well appreciated however, particularly as echocardiography is a powerful and widely available technique in valve disease. This review highlights the added value that CMR can bring in valve disease, complementing echocardiography in many areas, but it has also become the first-line investigation in some, such as pulmonary valve disease and assessing the right ventricle. CMR has many advantages, including the ability to image in any plane, which allows full visualisation of valves and their inflow/outflow tracts, direct measurement of valve area (particularly for stenotic valves), and characterisation of the associated great vessel anatomy (e.g. the aortic root and arch in aortic valve disease). A particular strength is the ability to quantify flow, which allows accurate measurement of regurgitation, cardiac shunt volumes/ratios and differential flow volumes (e.g. left and right pulmonary arteries). Quantification of ventricular volumes and mass is vital for determining the impact of valve disease on the heart, and CMR is the 'Gold standard' for this. Limitations of the technique include partial volume effects due to image slice thickness, and a low ability to identify small, highly mobile objects (such as vegetations) due to the need to acquire images over several cardiac cycles. The review examines the advantages and disadvantages of each imaging aspect in detail, and considers how CMR can be used optimally for each valve lesion.