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Ann Thorac Surg 2004;78:96-102
© 2004 The Society of Thoracic Surgeons

Original article: cardiovascular

Regurgitant jet evaluation using three-dimensional echocardiography and magnetic resonance

Joerg Albers, MDa*, Tobias Nitschea, Jan Boese, PhDb, Raffaele De Simone, MDa, Ivo Wolfc, Antje Schroedera, Christian F. Vahl, MDa

a Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany
b Biophysics, Heidelberg, Germany
c Medical and Biological Informatics, German Cancer Research Centre, Heidelberg, Germany

Accepted for publication November 25, 2003.

* Address reprint requests to Dr Albers, Department of Cardiac Surgery, University of Heidelberg, INF 110, 69120 Heidelberg, Germany
e-mail: oerg.albers{at}urz.uni-heidelberg.de

BACKGROUND: Three-dimensional assessment of regurgitant jet volume is the prerequisite for stratifying valve insufficiency. However, systematic comparison of three-dimensional methods is lacking. Therefore, we evaluated magnetic resonance imaging and three-dimensional echocardiography experimentally.

METHODS: An insufficiency chamber (22 x 18.5 x 27 cm; ostia 10, 16, and 20 mm; regurgitant volumes 2.3 to 25 mL) within experimental circulation (BioMedicus pump, tubes, pulsatile flow 0.2 to 1.9 L/min) was used for three-dimensional echocardiography (HP Sonos 2500) and magnetic resonance imaging (Siemens Magnetom Vision). Doppler flowmeter served as a gold standard. Segmentation used thresholding and surface integration of velocity vectors. Jet volume was evaluated qualitatively by polynom fitting.

RESULTS: Jet volume calculated by magnetic resonance (r = 0.99, p < 0.0001) and by echocardiography (r = 0.99, p < 0.0001) correlated identically to the gold standard. Jet volume derived from imaging correlated with each other by r = 0.98 (p < 0.0001). Polynom fits indicated a more paraboloid shape of magnetic resonance jet volume.

CONCLUSIONS: Experimentally, three-dimensional echocardiography and magnetic resonance imaging possess identical accuracy for determining regurgitant jet volume. Magnetic resonance imaging seems to provide qualitatively better image data for three-dimensional reconstruction.






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