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D Glogar

Publications and source records attributed to D Glogar.

113 records · Page 7Linked to original sources
PubMedDate not supplied

Quantification of regurgitant lesions by MRI.

We examined 46 patients with angiographically documented regurgitant lesions (26 patients with mitral regurgitation, 20 patients with aortic regurgitation) using an 0.5 Tesla magnet. In each patient a multislice-multiphase spinecho sequence in sagittal-coronal double angulated plane was performed to assess left and right ventricular volumes, ejection fraction and regurgitant fraction. Additionally a blood flow sensitive gradient echo technique was done to visualize direction and extension of the regurgitant jet. MRI data were compared with quantitative and qualitative assessment of regurgitation by angiography and echocardiography. Using the gradient echo technique MRI could demonstrate the regurgitant jet in all patients. A linear correlation for volume parameters by MRI and angio was found with best correlation for the left ventricular stroke volume (r = 0.82, p less than 0.0001). Furthermore MRI regurgitant fraction correlated with angiographically determined regurgitant fraction in patients with aortic regurgitation (r = 0.91, p less than 0.0001) and mitral regurgitation (r = 0.67, p less than 0.001), respectively. Semiquantitative assessment of regurgitation by gradient echo technique showed an agreement with angiographic grading by Sellers in 70% of mitral and 75% of aortic regurgitation, respectively. The comparison of MRI and color Doppler sonography showed only moderate correlation of r = 0.72 (p less than 0.01).

Aortic Valve Insufficiency↗
PubMedDate not supplied

Assessment of mitral regurgitation by magnetic resonance imaging.

To evaluate the potential of magnetic resonance imaging (MRI) in detection and quantification of mitral regurgitation, 26 pts. with echocardiographically or angiographically documented mitral regurgitation were examined using a 0.5 Tesla superconducting magnet. In each patient a multislice-multiphase study in a sagittal-coronal double angulated projection (four-chamber view equivalent) was performed to assess left and right ventricular volumes, ejection fraction and regurgitant fraction. Additionally a blood flow sensitive cine-study (fast field echo: FFE) was done to visualize direction and area of regurgitant jet. MRI data were compared with quantitative and quantitative assessment of mitral regurgitation by angiography, 2D echocardiography, Doppler sonography and color flow mapping. Using the FFE mode MRI was able to detect the regurgitant jet as a typical signal loss within the left atrium in all patients. The ratio of regurgitant jet area/left atrium area as determined by MRI showed a correlation with a comparable ratio from color Doppler sonography of R = 0.87 (p less than 0.001). There was also good agreement in semiquantitative grading of mitral regurgitation between MRI and angiography (R = 0.77, p less than 0.001). The determination of left and right ventricular stroke volume allowed the calculation of the regurgitant fraction, which showed a correlation with invasively determined regurgitation fraction of R = 0.84 (p less than 0.001). These data provide additional information that MRI may be useful as a noninvasive technique to detect and quantify mitral regurgitation.

Adult↗
PubMedDate not supplied

Value of three-dimensional echocardiography as an adjunct to conventional transesophageal echocardiography.

Three-dimensional imaging of cardiac structures could enhance the functional understanding and the interpretation of pathologies. Limited processing capabilities, relocation problems and inadequate two-dimensional image quality have previously limited its applicability. Recently, an integrated echocardiographic computerized tomography unit (echo-CT) which uses a transesophageal approach has been developed. This system is capable of sampling and processing multiple echocardiographic images and, thus, provides three-dimensional views. To evaluate the feasibility and potential of this technique, we studied 69 patients with various cardiac disorders. All but 3 patients (96%) tolerated the procedure well allowing at least one scan to be performed. No complications were encountered. The indication for echo-CT included coronary artery disease (n = 4), mitral valve disease (n = 18), suspected arterial embolism (n = 19), masses (n = 8), congenital malformation (n = 10), postcardiac surgery (n = 8), aortic aneurysm (n = 1) and suspected left-to-right shunt (n = 1). Conventional transesophageal echocardiography revealed a pathology in 45 patients. Of these pathologies, 37 (82%) could be reconstructed and displayed in three-dimensional views. Three-dimensional imaging provided an improved spatial understanding of the pathology in 21 cases (39%). Echo-CT was especially valuable in diseases of the mitral value (i.e. mitral valve prolapse, flail leaflets, mitral stenosis) where it had the potential to delineate the location, type and morphology of defects. In conclusion, three-dimensional transesophageal imaging enhances image interpretation and understanding. This could be of value in complex morphologies and cardiac disorders in which surgical repair is attempted.

Adult↗