PubMed · 9651971
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S K Alam, K J Parker. 1998. Color flow mapping.. https://doi.org/10.1016/s0301-5629(98)00015-5
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Longitudinal observations of tricuspid valve regurgitation were prospectively performed in 22 singleton fetuses with normal anatomy, normal biometry and normal Doppler to determine the characteristics of functional tricuspid valve regurgitation. Tricuspid valve regurgitation was semi-quantified by spatial and temporal Doppler-derived parameters. In 18 cases tricuspid valve regurgitation was part-systolic (early and mid-systolic) and showed little spatial expansion of the jet as examined by colour Doppler flow imaging. In 16 of these 18 cases the maximum velocity of these regurgitant jets was below 2.00 m/s. Four fetuses demonstrated holosystolic regurgitant jets and in addition to the longer duration of these jets, the spatial expansion was also greater and the maximum velocity was slightly higher compared with the part-systolic tricuspid valve regurgitations. Re-examination of the 22 normally grown fetuses showed that tricuspid valve regurgitation was a transient phenomenon. Within a period of one to seven weeks after the diagnosis of tricuspid valve regurgitation, the regurgitation could no longer be demonstrated in any of these cases, including the four fetuses with holosystolic regurgitant jets. Tricuspid valve regurgitation was the only detected abnormality in all of these cases. The fetal outcome of the 22 normally grown fetuses with tricuspid valve regurgitation was unremarkable concerning the evaluated parameters. Although fetal tricuspid valve regurgitation may be a sign of increased preload, afterload or cardiac dysfunction, in most cases tricuspid valve regurgitation is an isolated transient phenomenon with little temporal and spatial expansion; nevertheless in some cases holosystolic tricuspid valve regurgitation may also be an isolated transient finding, and it may be a functional phenomenon.
Congenital and acquired valvular disease remains a frequent cause of morbidity and mortality. It presents a diagnostic challenge in all age groups, and often occurs in conjunction with other types of heart disease. Traditional chest radiography provides the earliest opportunity for radiologic diagnosis, hence the need for skill and knowledge in interpreting the radiographic findings. Echocardiography with color flow Doppler measurements is frequently the next modality applied. CT and MR imaging can simultaneously display cardiovascular morphology with greater spatial resolution than ultrasound, and at the same time provide quantitative assessment of cardiac function. The role of diagnostic imaging is therefore crucial, both for primary diagnosis and in the management of valvular heart disease. Furthermore, it is fundamental in evaluating the results of all forms of interventional therapy.
Color Doppler echocardiography does not provide adequate information about the severity of mitral regurgitation in patients with eccentric mitral regurgitation. We have developed a new procedure for 3-dimensional (3D) color Doppler reconstruction and for segmentation of regurgitant jets. The volume of regurgitant jets was compared with jet area in 63 patients with mitral regurgitation. Mitral regurgitation was assessed by angiography, regurgitant fraction and volume by pulsed Doppler, JA by planimetry, and JV by 3-dimensional Doppler. Twenty-eight patients with central jets were compared with 35 patients with eccentric jets. In the patients with eccentric jets, JV showed significant correlations with regurgitant volume (r = 0.90; P <.01) and regurgitant fraction (r = 0.76; P < .01) and was able to separate groups with different degrees of mitral regurgitation (P <.01). Three-dimensional Doppler revealed origin, direction, and spatial spreading of complex jet geometry. JV, a new parameter of mitral regurgitation, was also capable of quantifying asymmetrical jets.