Cardiovascular magnetic resonance assessment of the aortic valve stenosis: an in vivo and ex vivo study.

Background: Aortic valve area (AVA) estimation in patients with aortic stenosis may be obtained using several methods. This study was undertaken to verify the cardiovascular magnetic resonance (CMR) planimetry of aortic stenosis by comparing the findings with invasive catheterization, transthoracic (TTE) as well as tranesophageal echocardiography (TEE) and anatomic CMR examination of autopsy specimens.

Methods: Our study was performed in eight patients with aortic valve stenosis.

Direct visualization of regurgitant orifice by CMR reveals differential asymmetry according to etiology of mitral regurgitation.

Objectives: This study sought to characterize the shape of regurgitant orifice area (ROA) and mitral apparatus in various forms of mitral regurgitation (MR) by cardiac magnetic resonance (CMR).

Background: ROA is an accepted parameter of MR severity. However, there are little data on the shape of the ROA in various forms of MR.

Variable phenotypes of bicuspid aortic valve disease: classification by cardiovascular magnetic resonance.

Background: Recently, cardiovascular magnetic resonance (CMR) has been shown to allow accurate visualisation and quantification of aortic valve disease. Although bicuspid aortic valve (BAV) disease is relatively rare in the general population, the frequency is high in patients requiring valve surgery. The aim of the current study was to characterise the different phenotypes of BAV disease by CMR.

Cardiovascular magnetic resonance for direct assessment of anatomic regurgitant orifice in mitral regurgitation.

Background: In patients with mitral regurgitation (MR), assessment of the severity of valvular dysfunction is crucial. Recently, regurgitant orifice area has been proposed as the most useful indicator of the severity of MR. The purpose of our study was to determine whether planimetry of the anatomic regurgitant orifice (ARO) in patients with MR is feasible by cardiovascular magnetic resonance (CMR) and correlates with invasive catheterization and echocardiography effective regurgitant orifice [ECHO-ERO] by proximal isovelocity surface area.

Electrocardiographic diagnosis of left ventricular hypertrophy in aortic valve disease: evaluation of ECG criteria by cardiovascular magnetic resonance.

Background: Left ventricular hypertrophy (LVH) is a hallmark of chronic pressure or volume overload of the left ventricle and is associated with risk of cardiovascular morbidity and mortality. The purpose was to evaluate different electrocardiographic criteria for LVH as determined by cardiovascular magnetic resonance (CMR). Additionally, the effects of concentric and eccentric LVH on depolarization and repolarization were assessed.

Quantification of left-to-right shunting in adult congenital heart disease: phase-contrast cine MRI compared with invasive oximetry.

Atrial septum defects (ASDs), ventricular septum defects (VSDs) and patent ductus arteriosus (PDA) are the most common adult congenital heart defects. The degree of left-to-right shunting as assessed by the ratio of flow in the pulmonary (Qp) and systemic circulation (Qs) is crucial in the management of these conditions. This study compared phase-contrast cine magnetic resonance imaging (PC-MRI), a non-invasive imaging technique, with invasive oximetry for the measurement of shunt volumes during cardiac catheterisation in adults with left-to-right shunting.

Dilatation of the ascending aorta in bicuspid aortic valve disease: a magnetic resonance imaging study.

Background: Bicuspid aortic valve disease (BAV) is increasingly recognized as a disease of the entire proximal aorta including both valvular and vascular complications. The aim of our study was to assess the dimensions of the thoracic aorta using MRI in a broad spectrum of BAV and tricuspid aortic valve disease (TAV) and to define the prevalence of the dilatation of the ascending aorta (AA) >or= 4.5 cm in severe BAV disease.

Unicuspid aortic valve disease: a magnetic resonance imaging study.

Purpose: Congenitally malformed aortic valves are a common finding in adults with aortic valve disease. Most of these patients have bicuspid aortic valve disease. Unicuspid aortic valve disease (UAV) is rare.

Time course of eosinophilic myocarditis visualized by CMR.

We report the diagnostic potential of cardiovascular magnetic resonance (CMR) to visualize the time course of eosinophilic myocarditis upon successful treatment. A 50-year-old man was admitted with a progressive heart failure. Endomyocardial biopsies were taken from the left ventricle because of a white blood cell count of 17000/mm3 with 41% eosinophils.

Triphasic mitral inflow pattern and regional triphasic mitral annulus velocity in hypertrophic cardiomyopathy.

In Doppler echocardiography, a triphasic mitral inflow filling pattern with a mid-diastolic flow velocity (L) is usually related to elevated filling pressures and delayed myocardial relaxation. Furthermore, additional triphasic mitral annulus velocity with a mid-diastolic component (L') at tissue Doppler imaging (TDI) demonstrates an even more advanced diastolic dysfunction. In this puzzling case, a triphasic and restrictive mitral inflow pattern was noted in 55-year-old patient with Hypertrophic Cardiomyopathy and a history of septal myectomy.

Assessment of the anatomic regurgitant orifice in aortic regurgitation: a clinical magnetic resonance imaging study.

Background: The aim of our study was to determine whether planimetry of the anatomic regurgitant orifice (ARO) in patients with aortic regurgitation (AR) by magnetic resonance imaging (MRI) is feasible and whether ARO by MRI correlates with the severity of AR.

Methods And Results: Planimetry of ARO by MRI was performed on a clinical magnetic resonance system (1.5 T Sonata, Siemens Medical Solutions) in 45 patients and correlated with the regurgitant fraction (RgF) and regurgitant volume (RgV) determined by MRI phase velocity mapping (PVM; MRI-RgF, MRI-RgV, n = 45) and with invasively quantified AR by supravalvular aortography (n = 32) and RgF upon cardiac catheterisation (CATH-RgF, n = 15).

General aneurysmatosis due to cheese consumption: complications of an endocarditis caused by Lactococcus cremoris.

We describe a case of endocarditis due to Lactococcus cremoris associated with cheese consumption, that caused multiple mycotic aneurysms. Antibiotic treatment combined with surgical and radiological interventions resulted in full recovery.

MRI planimetry for diagnosis and follow-up of valve area in mitral stenosis treated with valvuloplasty.

Purpose: We sought to determine whether noninvasive planimetry by magnetic resonance imaging (MRI) is suitably sensitive and reliable for visualizing the mitral valve area (MVA) and for detecting increases in the MVA after percutaneous balloon mitral valvuloplasty (PBMV).

Materials And Methods: In 8 patients with mitral valve stenosis, planimetry of the MVA was performed before and after PBMV with a 1.5 T MR scanner using a breath-hold balanced gradient echo sequence (True FISP).

Delayed hyperenhancement in magnetic resonance imaging of left ventricular hypertrophy caused by aortic stenosis and hypertrophic cardiomyopathy: visualisation of focal fibrosis.

Objective: To compare the extent and distribution of focal fibrosis by gadolinium contrast-enhanced magnetic resonance imaging (MRI; delayed hyperenhancement) in severe left ventricular (LV) hypertrophy in patients with pressure overload caused by aortic stenosis (AS) and with genetically determined hypertrophic cardiomyopathy (HCM).

Methods: 44 patients with symptomatic valvular AS (n = 22) and HCM (n = 22) were studied. Cine images were acquired with fast imaging with steady-state precession (trueFISP) on a 1.

Planimetry of aortic valve area in aortic stenosis by magnetic resonance imaging.

Background: The aim of the study was to determine whether noninvasive planimetry of aortic valve area (AVA) by magnetic resonance imaging (MRI) is feasible and reliable in patients with valvular aortic stenosis in comparison to transesophageal echocardiography (TEE) and catheterization.

Methods And Results: Planimetry of AVA by MRI (MRI-AVA) was performed on a clinical magnetic resonance system (1.5-T Sonata, Siemens Medical Solutions) in 33 patients and compared with AVA calculated invasively by the Gorlin-formula at catheterization (CATH-AVA, n = 33) as well as to AVA planimetry by multiplane TEE (TEE-AVA, n = 27).

Planimetry of mitral valve stenosis by magnetic resonance imaging.

Objectives: We sought to determine whether noninvasive planimetry of the mitral valve area (MVA) by magnetic resonance imaging (MRI) is feasible and reliable in patients with mitral stenosis (MS).

Background: Accurate assessment of MVA is particularly important for the management of patients with valvular stenosis. Current standard techniques for assessing the severity of MS include echocardiography (ECHO) and cardiac catheterization (CATH).

Structural and biomolecular changes in aorta and pulmonary trunk of patients with aortic aneurysm and valve disease: implications for the Ross procedure.

Objectives: A higher incidence of pulmonary autograft dilatation is assumed in patients with ascending aortic dilatation and bicuspid aortic valve disease. To examine whether structural abnormalities are present in the ascending aorta as well as in the pulmonary trunk (PT) we specifically addressed molecular mechanisms and signalling pathways for aneurysm formation in ascending aortic aneurysms and PT of patients with different aortic valve pathology undergoing an extended Ross procedure.

Methods: Wall segments resected from aortic aneurysms (20 patients, 7 bicuspid aortic valves BAV, and 13 tricuspid aortic valves TAV) and from PTs were submitted to analysis of leukocyte infiltration (immunohistochemistry), smooth muscle cell (SMC) apoptosis (in situ end-labelling of DNA-fragments TUNEL), and expression of death-promoting proteins perforin, granzyme B, Fas/FasL (immunoblotting).

Early regression of left ventricular hypertrophy after aortic valve replacement by the Ross procedure detected by cine MRI.

Aim: The primary objective of our study was to assess the time course of left ventricular remodeling after the Ross procedure with the use of cine magnetic resonance imaging (MRI).

Methods: In a prospective study, 10 patients with isolated aortic valve disease were examined prior to aortic valve surgery, as well as at early follow-up (mean 4 weeks) and at late follow-up (mean 8 months) after pulmonary autograft aortic valve replacement (Ross procedure). The heart was imaged with a 1.

[Evaluation of radiological teaching programs in the Internet].

Purpose: Evaluation of web based training programs, which can be contacted from the homepages of radiological departments of German universities.

Material And Method: From June 2000 to January 2002 the 75 web based training programs of 57 providers,which can be contacted from the web pages of the radiological departments of German universities were evaluated in a prospective study. A medical student experienced in using the world wide web examined each training program three times in an interval of six months using the following criteria: availability of the web sites, target group, kind of training program, contents and structure and the technical solution.

[Contrast-enhanced MR angiography in the routine work-up of the lower extremity arteries].

Purpose: Prospective evaluation of the effectiveness of contrast-enhanced moving-table magnetic resonance angiography (CE-MRA) as the sole routine tool for the diagnosis of peripheral arterial occlusive disease and determination whether it can replace catheter arteriography.

Subjects And Methods: In a time period of 23 weeks, 100 consecutive patients were evaluated. A total of 112 contrast-enhanced moving-table MR angiograms were performed at 1.

Left ventricular remodeling after pulmonary autograft aortic valve replacement: evaluation with color-Doppler echocardiography and magnetic resonance imaging.

The superior hemodynamic performance of the pulmonary autograft in aortic position is expected to reflect complete regression of hypertrophy and improved ventricular function. We evaluated and compared early and midterm transthoracic color-Doppler echocardiography (TTE) and magnetic resonance imaging (MRI) assessment concerning left ventricular (LV) function, LV mass regression, and performance of the semilunar valves. A total of 42 consecutive patients, mean age 36 +/- 6 years (range 15 to 56 years), were studied.

Magnetic resonance imaging in patients diagnosed with papilledema: a comparison of 6 different high-resolution T1- and T2(*)-weighted 3-dimensional and 2-dimensional sequences.

Purpose: To evaluate visualization and signal characteristics of macroscopic changes in patients with ophthalmologically stated papilledema and to find a suitable high-resolution magnetic resonance imaging (MRI) protocol.

Method: Nine consecutive patients with 12 ophthalmologically stated papilledemas underwent MRI of the head and orbits, which consisted of the following high-resolution sequences: 3-dimensional (3D), T2*-weighted (T2*w) constructive interference in steady-state sequence (CISS); 3D, T1-weighted (T1w) magnetization prepared-rapid gradient echo sequence (MP-RAGE) (with and without intravenous contrast medium); transverse 3D and 2-dimensional (2D) (2 mm), T2-weighted (T2w) turbo spin echo (TSE); transverse 2D (2 mm), contrast-enhanced T1w TSE with fat-suppression technique; and transverse 2D (5 mm), T2w TSE. A quantitative and qualitative evaluation of the papilla, optic nerve, optic nerve sheath, optic chiasm, and the brain was performed.

Peripheral arterial balloon angioplasty: effect of short versus long balloon inflation times on the morphologic results.

Purpose: To evaluate the effect of different balloon inflation times on angiographic results in peripheral angioplasty.

Materials And Methods: Seventy-four infrainguinal arteriosclerotic lesions were randomized prospectively to undergo balloon dilation for 30 seconds (group I) or 180 seconds (group II). Each group consisted of 37 patients.

[Treatment of para-ostium renal artery stenoses with a new, solidly premounted balloon expandable stent].

Purpose: Evaluation of the handling, technical success rate, and six-months patency rate of a new, premounted balloon-expandable stent in ostial renal artery stenoses.

Material And Methods: In a prospective study, 27 ostial renal artery stenoses in 20 patients were primarily treated with the new "Renal Bridge Stent" (Medtronic AVE, Düsseldorf). All patients had a history of hypertension and 8 patients had renal dysfunction.