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Physiology - Radiology and Medical Imaging

Clinical Application of Cine-MRI in the Visual Assessment of Mitral Regurgitation Compared to Echocardiography and Cardiac Catheterization
Published: Tuesday, July 17, 2012
Author: John Heitner et al.

by John Heitner, Geetha P. Bhumireddy, Anna Lisa Crowley, Jonathan Weinsaft, Salman A. Haq, Igor Klem, Raymond J. Kim, James G. Jollis


Detecting and quantifying the severity of mitral regurgitation is essential for risk stratification and clinical decision-making regarding timing of surgery. Our objective was to assess specific visual parameters by cine-magnetic resonance imaging (MRI) in the determination of the severity of mitral regurgitation and to compare it to previously validated imaging modalities: echocardiography and cardiac ventriculography.


The study population consisted of 68 patients who underwent a cardiac MRI followed by an echocardiogram within a median time of 2.0 days and 49 of these patients who had a cardiac catheterization, median time of 2.0 days. The inter-rater agreement statistic (Kappa) was used to evaluate the agreement.


There was moderate agreement between cine MRI and Doppler echocardiography in assessing mitral regurgitation severity, with a kappa value of 0.47, confidence interval (CI) 0.29–0.65. There was also fair agreement between cine MRI and cardiac catheterization with a kappa value of 0.36, CI of 0.17–0.55.


Cine MRI offers a reasonable alternative to both Doppler echocardiography and, to a lesser extent, cardiac catheterization for visually assessing the severity of mitral regurgitation with specific visual parameters during routine clinical cardiac MRI.