ReviewsCardiac magnetic resonance ‘virtual catheterization’ for the quantification of valvular regurgitations and cardiac shuntAquaro, Giovanni Donato; Barison, Andrea; Todiere, Giancarlo; Festa, Pierluigi; Ait-Ali, Lamia; Lombardi, Massimo; Di Bella, Gianluca On the behalf of the working group ‘Applicazioni della Risonanza Magnetica’ of the Italian Society of CardiologyAuthor Information aFondazione G. Monasterio CNR-Regione Toscana, Pisa and Massa bMultimodality Cardiac Imaging Section, San Donato, Milan cDipartimento di Medicina Clinica e Strumentale, University of Messina, Messina, Italy Correspondence to Giovanni Donato Aquaro, MD, G. Monasterio Foundation, Pisa, Via Moruzzi, 1 56124 Pisa, Italy Tel: +39 050 315 2818; fax: +39 050 315 2166; e-mail: [email protected] Received 22 May, 2014 Revised 25 October, 2014 Accepted 27 October, 2014 Journal of Cardiovascular Medicine: October 2015 - Volume 16 - Issue 10 - p 663 doi: 10.2459/JCM.0000000000000245 Buy Metrics Abstract Cardiac magnetic resonance (CMR) is considered the gold-standard noninvasive technique for the quantification of ventricular volumes by cine-imaging and of vascular flows by velocity-encoded phase contrast (VENC). In routine CMR scans, it is common to found clinical conditions, as valve regurgitations and cardiac shunts, producing a volume overload and significant mismatch between the right and left ventricular stroke volumes (RSV and LSV). In the presence of a valve regurgitation, the volume overload involves the respective ventricular chamber, whereas in cardiac shunts, the location of the volume overload depends on the site of the anatomic defect. Moreover, when a cardiac shunt is present, pulmonary and systemic cardiac outputs are different (Qp/Qs < 1 or Qp/Qs > 1), whereas in the presence of valve regurgitation, Qp/Qs = 1. Therefore, by combining the cine-imaging with the VENC technique, it is possible to investigate the cardiac physiology underlying different pathological conditions producing volume overload, and to quantify this overload (the regurgitant volume and/or shunt volume). In this report, we discussed the technical, theoretical and methodological aspects of this sort of ‘virtual catheterization’ by CMR, providing a simple algorithm to make the correct diagnosis. © 2015 Italian Federation of Cardiology. All rights reserved.