Non-invasive approach and semi-quantitative evaluation of mitral regurgitation by cine-MRI, transthoracic and transoesophageal echography

Assessment of mitral regurgitation has always been difficult (even with invasive methods). Cine-MRI, able to define mitral regurgitant flow, owing to produced signal void, has been compared in 50 patients with other non-invasive techniques (transthoracic and transoesophageal echography-TTE & TOE) with reference to invasive left ventriculography (LVA). Sensitivity of cine-MRI is 98%; inter-observer reproductibility is best in TOE but remains good in cine-MRI. Linear correlations between TTE, TOE and LVA are very good; so are also correlations between cine-MRI and all other techniques (the best 0.88-with TOE). The highest correlation appears between total non-invasive methods and LVA. Therefore cine-MRI is to be used in association with TEE in routine, by first intention as non-invasive method of valuation in mitral regurgitation. TOE may be added if necessary, but LVA seems now no more useful