Multi-parametric quantification of tricuspid regurgitation using cardiovascular magnetic resonance: A comparison to echocardiography

Background: Velocity-encoding is used to quantify tricuspid regurgitation (TR) by cardiovascular magnetic resonance (CMR), but requires additional dedicated imaging. We hypothesized that size and signal intensity (SI) of the cross-sectional TR jet area in the right atrium in short-axis steady-state free-precession images could be used to assess TR severity. Methods: We studied 61 patients with TR, who underwent CMR and echocardiography within 24 h. TR severity was determined by vena contracta: severe (N = 20), moderate or mild (N = 41). CMR TR jet area and normalized SI were measured in the plane and frame that depicted maximum area. ROC analysis was performed in 21/61 patients to determine diagnostic accuracy of differentiating degrees of TR. Optimal cutoffs were independently tested in the remaining 40 patients. Results: Measurable regions of signal loss depicting TR jets were noted in 51/61 patients, while 9/10 remaining patients had mild TR by echocardiography. With increasing TR severity, jet area significantly increased (15 +/- 14 to 38 +/- 20 mm(2)), while normalized SI decreased (57 +/- 27 to 23 +/- 11). ROC analysis showed high AUC values in the derivation group and good accuracy in the test group. Conclusion: TR can be quantified from short-axis CMR images in agreement with echocardiography, while circumventing additional image acquisition. (C) 2016 Elsevier Ireland Ltd. All rights reserved.