POSTER SECTIONS Coverpage Learning objectives Background Findings and procedure details Conclusion Personal information and conflict of interest References

ECR 2024 / C-10082

Mitral valve dysjunction: all the radiologist needs to know

Congress:

ECR 2024

Poster Number:

C-10082

Type:

Educational Exhibit

Keywords:

Cardiac, MR, Normal variants, Congenital

Authors:

A. Gil Boronat, M. D. L. �. Méndez, P. Torres Rubio, J. Alarcón Rodríguez, J. J. Martín Pinacho, �. Arribas Marcos, M. �. Gómez Bermejo

DOI:

10.26044/ecr2024/C-10082

DOI-Link:

https://dx.doi.org/10.26044/ecr2024/C-10082

References

4. REFERENCES

Souza, Alexandre Costa, et al. "Disjunção do Anel Mitral: Modalidades Diagnósticas, Implicações Clínicas e Evolução Prognóstica.”

Wu, Stephanie, and Robert J. Siegel. "Mitral annular disjunction: A case series and review of the literature." Frontiers in Cardiovascular Medicine 9 (2022): 976066.

Hernández, Keerby, et al. "The mitral annulus disjunction as a risk marker in mitral valve prolapse." Arch Cardiol Mex (Eng)91.3 (2021): 313-320

Perazzolo Marra, Martina, et al. "Morphofunctional abnormalities of mitral annulus and arrhythmic mitral valve prolapse." Circulation: Cardiovascular Imaging 9.8 (2016): e005030.

Zugwitz, Dasa, et al. "Mitral annular disjunction assessed using CMR imaging: insights from the UK biobank population study." Cardiovascular Imaging 15.11 (2022): 1856-1866.

Wunderlich, Nina C., et al. "Myxomatous mitral valve disease with mitral valve prolapse and mitral annular disjunction: clinical and functional significance of the coincidence." Journal of Cardiovascular Development and Disease 8.2 (2021): 9.

Figliozzi, Stefano, et al. "Myocardial fibrosis at cardiac MRI helps predict adverse clinical outcome in patients with mitral valve prolapse." Radiology 306.1 (2023): 112-121.

Padala, Muralidhar, et al. "Saddle shape of the mitral annulus reduces systolic strains on the P2 segment of the posterior mitral leaflet." The Annals of thoracic surgery 88.5 (2009): 1499-1504.

Morris, Michael F., et al. "CT and MR imaging of the mitral valve: radiologic-pathologic correlation." Radiographics 30.6 (2010): 1603-1620.

Fig 1: Perazzolo Marra, Martina, et al. "Morphofunctional abnormalities of mitral...

Fig 2: Diagram and 3C view of mitral valve disjunction. It is measured from the top of...

Fig 3: 2C view of mitral valve. Image 1 shows a normal anatomical relationship between...

Fig 4: Image shows normal anterior (A1, A2, A3) and posterior (P1, P2, P3) mitral...

Fig 5: Images 1 and 2: 3C TTE showing annular expansion at end -systole phase, going...

Fig 6: Image 1: Degree of saddle defined as the ratio of annular height (H) to...

Fig 7: Images 1 and 2 showing the appearance of the dancer’s foot. Image 3: MRI 3C...

Fig 8: Figure 1: Global longitudinal strain (GLS) in a patient with mitral annulus...

Fig 9: Figure 1 and 2: Global longitudinal strain (GLS) in patients with mitral...

Fig 10: Cardiac Magentic Resonance planes used for assessment of mitral AV junction....

Fig 11: 3C view showing a postero/ inferolateral disjunction. Severe mitral...

Fig 12: Image 1 and 2: 3C and 4C views. Showing a displacement of 7 mm of the posterior...

Fig 13: 3C view. Posterolateral disjunction, type III. Mitral valve disjunction with...

Fig 14: Showing a type II inferior disjunction (2 mm) in a 2C-view.

$Fig 15: Image 1 to 5: 4C, 3C, 2C, 2C and 3C view respectively. Dysplastic mitral valve with disjunction of both leaflet insertions concerning the basal ventricular myocardium up to 14 mm (type III). All valvular circumference (posterolateral, inferolateral, anterior/superior and inferior) is affected. Marked elongation of anterior veil and important prolapse (yellow circle). Mitral regurgitation is estimated as mild with a regurgitation fraction of 11%.$

Fig 15: Image 1 to 5: 4C, 3C, 2C, 2C and 3C view respectively. Dysplastic mitral valve...

Fig 16: Image 1 to 4: Posterolateral disjunction of 11.5 mm in 3C view and...

Fig 17: Image 1 (2C view) shows mitral leaflet thickening (marked with a yellow arrow)....

Fig 18: Images 7 (4C) and 8 (short axis) show fragmented / duplicated papillary muscles...

Fig 19: Image 1: 2C-view. Anterior (9.7 mm) and posterior (10.8 mm) leaflet prolapse....

Fig 20: Images 1 and 2 (sequential 2C-views) and image 3 (4C view) show a myxomatous...

Fig 21: Image 1: Important mitral regurgitation jet is displayed.

Fig 22: Images 1 (Short-axis view) and 2 (2C view) show myocardial enhancement in the...

Fig 23: Image 1 and 2: 4C views. The images show an apparent separation between the...

Fig 24: Image 1 shows elongation and marked thickening of the mitral valvular...