Bicuspid aortic stenosis MRI

Overview
Magnetic resonance imaging can be helpful as a diagnostic tool in conditions where the echocardiographic findings are inconclusive.

Magnetic Resonance Imaging
Bicuspid aortic valves are often associated with dilatation of the aortic root or ascending thoracic aorta, which can lead to aortic aneurysm or aortic dissection. Visualization of mid aorta may be difficult with echocardiography and during such instances, MRI or CT are helpful to evaluate for aneurysm or dissection in aorta.

Magnetic resonance imaging (MRI) can be used as a diagnostic modality in aortic stenosis.

Advantages of using MRI include:


 * It can be used in cases where echocardiographic results are inconclusive.
 * Helps in measuring heart volumes, blood flow and ventricular wall thickness.
 * The magnetic resonance angiography helps in better visualization of heart vasculature.
 * Phase velocity mapping helps in measuring the ratio of pulmonary to systemic blood flow (Qp:Qs).

==ACC/AHA Guidelines for MRI in Patients with Bicuspid Aortic Valve == {{cquote|

Class I
1. Cardiac magnetic resonance imaging or cardiac computed tomography is indicated in patients with bicuspid aortic valves when morphology of the aortic root or ascending aorta cannot be assessed accurately by echocardiography. (Level of Evidence: C)

2. Patients with bicuspid aortic valves and dilatation of the aortic root or ascending aorta (diameter > 4.0 cm*) should undergo serial evaluation of aortic root/ascending aorta size and morphology by echocardiography, cardiac magnetic resonance, or computed tomography on a yearly basis. (Level of Evidence: C)

Class IIa
1. Cardiac magnetic resonance imaging or cardiac computed tomography is reasonable in patients with bicuspid aortic valves when aortic root dilatation is detected by echocardiography to further quantify severity of dilatation and involvement of the ascending aorta. (Level of Evidence: B)

*Consider lower threshold values for patients of small stature of either gender.}}