Diagnostic Value of Cardiac MRI in Aortic Valve Stenosis in Comparison with Echocardiography

Background: Aortic stenosis is a common problem. The principle cause of aortic stenosis is the age-related progressive calcification of the tri-leaflet valve. During the course of aortic stenosis, the pressure gradient increases and the orifice area decreases. Transthoracic Echocardiography (TTE) is the method of choice to determine the severity of aortic stenosis, however, the ultrasound has its limitations. Trans-Esophageal Echo (TEE) is not tolerated by many patients and direct planimetry is difficult in patients with heavy calcifications.Methods: 59 patients of all age groups with aortic stenosis were examined using two dimensional echocardiography and non-contrast cardiac MRI (CMR) for assessment of the aortic valve area and aortic pressure gradient. Statistical analysis was conducted using the mean, standard deviation, student t- test and Linear Correlation tests.Results: Good correlation was obtained between the CMR and echocardiography regarding the mean velocity, mean pressure gradient across the valve, the aortic valve area and regarding the left ventricular function and morphology.Conclusion: CMR has shown its value as a diagnostic tool for determining the severity of an aortic valve stenosis. Ultrasound remains the method of choice, but in difficult to image patients and in non-conclusive sonographic findings, CMR could be a substitute for invasive catheter.