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Query: UMLS:C0232605 (regurgitation)
 8,217 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report a case showing supranuclear vertical gaze palsy and convergence nystagmus caused by a unilateral lesion of the rostral interstitial nucleus of the medial longitudinal fasciculus (riMLF). The patient was a 54-year-old female with mitral stenosis and regurgitation and atrial fibrillation, who suddenly developed vertigo and double vision. She was admitted to our hospital because of persisting diplopia 4 days after onset, although vertigo had resolved within 1 hour. On admission she was alert, but presented with supranuclear vertical gaze palsy and convergence nystagmus. Other cranial nerves were intact and motor strength, deep tendon reflexes, sensations were also normal. There were no cerebellar signs. Cranial MRI demonstrated a unilateral ischemic lesion at the left thalamo-mesencephalic junction that involved the unilateral riMLF. Cerebral angiography revealed no abnormalities. Vertical gaze palsy has been reported to be caused by a lesion involving bilateral riMLF or unilateral posterior commissure, and convergence nystagmus usually by a lesion near or within the dorsal mesencephalon. However, recent reports have demonstrated a histopathologic evidence that vertical gaze palsy was caused by unilateral riMLF lesion. The present case confirms clinically that both vertical gaze palsy and convergence nystagmus can be developed by a lesion of unilateral riMLF.
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PMID:[Supranuclear vertical gaze palsy and convergence nystagmus caused by unilateral riMLF lesion]. 181 94

Two cases of bronchogenic cysts involving esophagus are reported. The first case concerns a 30 year-old man, who admitted for dysphagia, regurgitation and abdominal pain. Barium esophagography, esophagoscopy and CT scan showed a cystic mass involving the lower third of the esophageal wall. Treatment consisted in the resection of the cyst by left thoracic approach. The second case concerns a 26 year-old woman, admitted for dysphagia. MRI and endoscopic ultrasonography had contributed to define the exact nature, internal composition and location of the cyst: upper and posterior mediastinum, close to the esophagus but respecting all the esophageal layers. Treatment consisted in the resection by video-thoracoscopy. Histologically, these two cysts were typical bronchogenic cysts. These two cases allowed us to discuss the benefits of new imaging methods (CT scan, MRI, endoscopic US) in the diagnosis of cystic masses of the mediastinum, and to emphasize video-surgery in their treatment.
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PMID:[Bronchogenic cysts of the esophagus. Classical surgery or video-surgery?]. 184 53

Cardiac cine field echo MRI and color Doppler were performed in 13 patients with aortic regurgitation (n = 4) or multiple valvular diseases (n = 9). The size, shape, and direction of regurgitation jets correlated well. Color Doppler was better able to follow flow jets in oblique planes. Cine MRI was better able to evaluate patients with marked cardiac dilatation.
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PMID:Cardiac MRI cine and color Doppler in valvular disease: correlative imaging. 188 Dec 52

As indicated by the 22 illustrative cases included in this monograph, a stepwise approach to the assessment of valvular heart disease provides the information necessary to make good clinical decisions. The ECG and chest x-ray add useful information to the history and physical examination. Echocardiography, Doppler, and color flow Doppler techniques have an important role in defining the presence and severity of valvular stenosis and regurgitation. Nuclear techniques provide useful information about global biventricular systolic function, regional wall motion, and myocardial perfusion. Exercise testing is most valuable in confirming objectively the patient's functional status and exercise tolerance. Newer imaging techniques, such as cine CT and MRI, are capable of displaying and measuring cardiac chamber size and myocardial thickness; however, visualization of the cardiac valves and demonstration of flow abnormalities are difficult, limiting the current usefulness of these techniques in patients with valvular heart disease.
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PMID:Management of valvular heart disease: an illustrative cases approach. 201 74

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).
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PMID:Quantification of regurgitant lesions by MRI. 209 4

We have examined 46 patients with angiographically confirmed regurgitant lesions (26 mitral insufficiency, 20 aortic insufficiency) using a 0.5 Tesla magnet. In each patient, multiplane and multiphase spin-echo sequences were obtained in a plane angled in the sagittal and coronal direction in the long axis of the heart; left and right ventricular volumes, ejection fractions and regurgitation fractions were calculated. In addition, a blood-flow sensitive gradient echo sequence was obtained in order to determine the direction and extent of the regurgitant jet. The data was compared with the results of angiography and echocardiography. By means of the gradient echo technique, MRI was able to show the regurgitant jet in every patient. There was a linear correlation between volumes determined by MRI and angiography. The best agreement was found for left ventricular contraction volume (R = 0.82, p is less than 0.0001). Comparison of the noninvasive and angiographic method showed a linear correlation for AI patients of R = 0.91 (p is less than 0.001), which is somewhat better than for patients with MI (R = 0.84, p less than 0.001). Semiquantitative grading of MI with a gradient echo technique showed a linear correlation with angiography of R = 0.73 (p less than 0.001), for AI there was agreement between both methods in 72% of cases. A comparison between MRI and colour Doppler sonography showed only moderately good correlation R = 0.69 (p less than 0.01).
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PMID:[Cine-MR for the quantification of regurgitation defects by a volume method]. 217 12

Fourty-five subjects--10 normal volunteers and 35 patients with valvular insufficiency were examined with MRI and [20 of them with mitral (MI) and 15 with aortic (AI) insufficiency] were evaluated with MR imaging and with Doppler echocardiography (echo-Doppler); 22 of these patients were also studied with angiocardiography. The extent of regurgitation jet was classified as follows: minimal (1+), mild (2+), moderate (3+), and severe (4+), according to the max distance of regurgitant jet signal from valvular leaflets. In our series, MR imaging with FFE sequences always showed the regurgitant jet. High agreement was found between MR and echo-Doppler results (80% for MI, and 86% for AI). In 22 patients who underwent angiocardiography, we observed 73% agreement. Cine-MR imaging proved to be an accurate and sensitive technique to recognize and to evaluate severity of regurgitant valvular flow in patients with AI and MI. This technique may be useful in those patients in whom Doppler echocardiography is inadequate or impossible to perform.
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PMID:[Magnetic resonance imaging of aortic and mitral valve insufficiency. Comparison with Doppler echocardiography and angiocardiography]. 226 71

Thirty-three patients presenting with regurgitation of the mitral valve (19 cases), tricuspid valve (14 cases) or aortic valve (11 cases) documented by angiography (n = 20) and/or doppler-echocardiography (n = 28) were examined by cine-MRI in order to test this method in valvular regurgitation. Sixteen ECG-synchronized cine-MRI images were acquired by the GRASS technique every 40 ms on appropriate projections, with a resistive 0.28 Tesla Bruker magnet. The semiology of normal and pathological blood flow images at cine-MRI is described. Valvular regurgitations present as "signal void" jets the chronology and spatial extension of which depend on the severity of the lesion. The differential diagnosis with physiological flows is discussed. The diagnostic sensitivity of the method was 29/29 when compared with angiography and 29/33 when compared with doppler-echocardiography (2 cases of 1/4 mitral regurgitation and 2 cases 1/4 tricuspid regurgitation were not visible at cine-MRI). The specificity of this method, as can be judged from 104 patients explored, also seems to be satisfactory. The severity of regurgitation was graded from 1 to 4 with the three methods, on the basis of strict criteria. The differences in grade evaluation exceeded +/- 1 point in only one case of mitral regurgitation which was greatly underestimated by the doppler method as compared with angiography and cine-MRI. Thus, cine-MRI is a reliable method to evaluate valvular regurgitations and their severity. It solves the practical problem raised by non-echogenic patients when catheterization is to be postponed or avoided.
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PMID:[Value of cine magnetic resonance imaging in the diagnosis and quantification of valvular regurgitation. Comparison with angiography and Doppler echocardiography]. 251 68

Seventy-six aortic and mitral valves, in 44 patients and 5 normal volunteers, were studied by Cine-Flow MRI (on a 0.26-T superconducting magnet system), utilizing compound oblique imaging planes and a Field Echo Even Rephasing sequence. All patients had had cardiac catheterization and echocardiography. All patients with valvular stenosis and aortic sclerosis (n = 45) showed complete signal loss distal to the respective valve. Length of signal loss distal to the aortic valve in those in whom it was measured (n = 15) allowed differentiation of aortic stenosis (n = 9) from sclerosis (n = 6). This also permitted grading of stenosis with highly significant correlation (T = 0.86; P less than 0.002) with pressure gradient measurement. In mitral stenosis (n = 12) calculation of the area of signal loss distal to the mitral valve as a percentage of left ventricular cross-sectional area showed a highly significant correlation (T = 0.77; P = 0.001) with pressure gradient measurement. Clinically significant valvular regurgitation was graded by size and duration of signal loss proximal to the value with concordance with angiocardiography. It is concluded that Cine-Flow MRI has a clinical role in the diagnosis and assessment of valvular heart disease.
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PMID:Diagnosis and assessment of mitral and aortic valve disease by cine-flow magnetic resonance imaging. 261 26

Magnetic resonance imaging provides three-dimensional images of the heart with good spatial and temporal resolution. Therefore, right and left ventricular function can be assessed without assumptions regarding ventricular morphology. Depiction of intracardiac blood flow with gradient echo sequences permits estimation of the severity of valvular regurgitation. Using improved paramagnetic contrast media magnetic resonance imaging may be able to directly visualize regions of ischemic myocardium. Real-time imaging of the heart will be possible using echo planar techniques. Although quantification of cardiac parameters by MRI is still mainly a research tool, clinical applications will emerge in the near future.
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PMID:[Possibilities and limits of quantitative image analysis using magnetic resonance procedures]. 269 49


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