Fig. 4: Time-resolved velocity vector visualization with CMR of dynamically changing MR jet.
From: Assessment of mitral valve regurgitation by cardiovascular magnetic resonance imaging
The top row shows cardiovascular magnetic resonance imaging (CMR) of three-chamber cines acquired during four phases of the cardiac cycle: end diastole, early systole, mid systole and late systole. The second row of images shows velocity vectors in the left atrium and the left ventricle superimposed on the three-chamber cines. These images allow the visualization of the A2–P2 scallops, demonstrating early systolic prolapse of the P2 scallop (orange arrow) resulting in a mitral regurgitation (MR) jet directed towards the medial interatrial septum, which settles in mid systole. A late-systolic, posteriorly directed MR jet (yellow arrow) can be appreciated as a result of A2 prolapse. The MR volume is quantified in the lower panel. This example highlights how cine CMR and augmented streamline visualization of the 4D-flow CMR can help to make a more dynamic pathophysiological diagnosis of the cause of MR. MVSV, mitral valve stroke volume.
