Normal signal-void patterns in cardiac cine MR images

The diagnosis of valvular regurgitation and stenosis with cardiac cine magnetic resonance (MR) imaging is based on observation of localized regions of signal void. However, areas of signal void frequently are present in patients without cardiac abnormalities and may closely resemble signal-void areas that occur secondary to valvular pathologic conditions. Twenty healthy volunteers were prospectively evaluated with gradient-echo cine MR imaging to determine the frequency, distribution, and timing of appearance of regions of signal void in the healthy population. The most frequent sites included the regions adjacent to the atrioventricular valves, the left ventricular outflow tract, atrial appendages, and areas of venous inflow, including the coronary sinus, superior vena cava, and pulmonary veins. Awareness of normal signal-void areas and their characteristics is critical in the assessment of cardiac cine MR examinations.