A study of intracardiac blood flow by MRI using gradient echo method

In order to investigate the possibility of MR imaging for the evaluation of intracardiac blood flow especially valvular regurgitant flow, we obtained MR images using a 1.5 tesla superconductive magnet system (Siemens Medical) in 3 healthy volunteers, 3 patients with hypertrophic cardiomyopathy and 8 patients with valvular heart disease. Rapid FLASH (Fast Low-Angle Shot) imaging technique was applied to collect 11 time frames per section throughout one cardiac cycle in axial, coronal, saggital and oblique sections. Then these sequential frames were displayed in a cine mode on CRT. (1) Intracardiac and intravascular blood flow were visualized with high signal intensity in each frame and cardiac structures such as atria, ventricles, and aorta were also identified in all subjects. (2) Ventricular ejection flow was easily visualized in coronal section as the signal loss in the ascending aorta. Ventricularfilling was visualized in axial and oblique sections as the high signal influx of atrial blood into the ventricle. (3) In 3 patients with aortic regurgitation, regurgitant flow was detected during diastole as the teardrop shaped signal loss originating from aortic valve cusps. (4) Both mitral and tricuspid regurgitant flow were detected during systole as the signal loss in atrium in axial and oblique sections in 2 patients with MR and 2 patients with TR. (5) Pulmonary regurgitant flow was observed in oblique section along the long axis of right ventricular outflow tract. These results indicate that intracardiac forward and regurgitant flow could be identified with rapid FLASH imaging in normal subjects and in patients with valvular heart diseases, and cine mode MR imaging is a useful tool for the evaluation of intracardiac blood flow. (author)