SPHP Radiology Protocols

AORTIC VALVE VIEWS

1. Begin with 3 chamber.

Plan off "Snowman" slice of short-axis stack AND 4 chamber.

If doing before you have short-axis stack, then 3 point plan (LV apex, LA, proximal aorta)

(NOTE dephasing jet in ascending aorta from Aortic Stenosis)

2. BISECT mid aorta, make Perpendicular

This results in the coronal LVOT view. Note the turbulent aortic jet from aortic stenosis. Now you have two orthogonal views of the left ventricular outflow tract (LVOT).

Diastole

Systole

3. Plan the AORTIC VALVE CINE slices parallel to aortic valve on BOTH the 3 CHAMBER and CORONAL LVOT views...

Use thinner Aortic Valve TrueFISPs, 0 spacing. This results in multiple views of the aortic valve in plane. A representative image of a stenotic valve in systole:

4. Optional RADIAL CINE stack through aortic valve.

Advantage: Low FOV, no phase wrap with radial acquisitions.

Disadvantage: Decreased quality with calcified aortic valve

5. Aorta Through Plane Phase Contrast

Plan single slice off 3 CHAMBER and CORONAL LVOT at sinotubular junction (where tulip bulb meets aorta)

If stenotic jet, make the slice perpendicular to the JET, not parallel to valve as the jets are often ECCENTRIC

If no stenotic jet, make the slice perpendicular to the aortic lumen

VENC starts at 150 for no stenosis. If you see a jet, can start a little higher (200)

This results in the following phase contrast cine with ALIASING (the black in the middle of the white):

This sequence must be repeated with incrementally higher VENCs until the aliasing is completely gone, resulting in this image (all white in aortic lumen):