BACKGROUND: Velocity-encoding is used to quantify tricuspid regurgitation (TR) by cardiovascular magnetic resonance (CMR), but requires additional dedicated imaging. We hypothesized that size and signal intensity (SI) of the cross-sectional TR jet area in the right atrium in short-axis steady-state free-precession images could be used to assess TR severity. METHODS: We studied 61 patients with TR, who underwent CMR and echocardiography within 24h. TR severity was determined by vena contracta: severe (N=20), moderate or mild (N=41). CMR TR jet area and normalized SI were measured in the plane and frame that depicted maximum area. ROC analysis was performed in 21/61 patients to determine diagnostic accuracy of differentiating degrees of TR. Optimal cutoffs were independently tested in the remaining 40 patients. RESULTS: Measurable regions of signal loss depicting TR jets were noted in 51/61 patients, while 9/10 remaining patients had mild TR by echocardiography. With increasing TR severity, jet area significantly increased (15±14 to 38±20mm2), while normalized SI decreased (57±27 to 23±11). ROC analysis showed high AUC values in the derivation group and good accuracy in the test group. CONCLUSION: TR can be quantified from short-axis CMR images in agreement with echocardiography, while circumventing additional image acquisition.
BACKGROUND: Velocity-encoding is used to quantify tricuspid regurgitation (TR) by cardiovascular magnetic resonance (CMR), but requires additional dedicated imaging. We hypothesized that size and signal intensity (SI) of the cross-sectional TR jet area in the right atrium in short-axis steady-state free-precession images could be used to assess TR severity. METHODS: We studied 61 patients with TR, who underwent CMR and echocardiography within 24h. TR severity was determined by vena contracta: severe (N=20), moderate or mild (N=41). CMR TR jet area and normalized SI were measured in the plane and frame that depicted maximum area. ROC analysis was performed in 21/61 patients to determine diagnostic accuracy of differentiating degrees of TR. Optimal cutoffs were independently tested in the remaining 40 patients. RESULTS: Measurable regions of signal loss depicting TR jets were noted in 51/61 patients, while 9/10 remaining patients had mild TR by echocardiography. With increasing TR severity, jet area significantly increased (15±14 to 38±20mm2), while normalized SI decreased (57±27 to 23±11). ROC analysis showed high AUC values in the derivation group and good accuracy in the test group. CONCLUSION: TR can be quantified from short-axis CMR images in agreement with echocardiography, while circumventing additional image acquisition.
Authors: N Fujita; A F Chazouilleres; J J Hartiala; M O'Sullivan; P Heidenreich; J D Kaplan; H Sakuma; E Foster; G R Caputo; C B Higgins Journal: J Am Coll Cardiol Date: 1994-03-15 Impact factor: 24.094