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Flow imaging of the mitral valve, however, is challenging, since it moves in and out of the image plane during the cardiac cycle.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To more accurately measure mitral flow, a slice\u2010following MRI phase contrast sequence is proposed. This study aimed to implement such a sequence, validate its slice\u2010following functionality in a phantom and healthy subjects, and test its feasibility in patients with mitral valve dysfunction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Type<\/jats:title><jats:p>Prospective.<\/jats:p><\/jats:sec><jats:sec><jats:title>Phantom and Subjects<\/jats:title><jats:p>The slice\u2010following functionality was validated in a cone\u2010shaped phantom by measuring the depicted slice radius. Sixteen healthy subjects and 10 mitral valve dysfunction patients were enrolled at two sites.<\/jats:p><\/jats:sec><jats:sec><jats:title>Field Strength\/Sequence<\/jats:title><jats:p>1.5T and 3T gradient echo cine phase contrast.<\/jats:p><\/jats:sec><jats:sec><jats:title>Assessment<\/jats:title><jats:p>A single breath\u2010hold retrospectively gated sequence using offline feature\u2010tracking of the mitral valve was developed. Valve displacements were measured and imported to the scanner, allowing the slice position to change dynamically based on the cardiac phase. Mitral valve imaging was performed with slice\u2010following and static imaging planes. Validation was performed by comparing mitral stroke volume with planimetric and aortic stroke volume.<\/jats:p><\/jats:sec><jats:sec><jats:title>Statistical Tests<\/jats:title><jats:p>Measurements were compared using linear regression, Pearson's R, parametric paired <jats:italic>t<\/jats:italic>\u2010tests, Bland\u2013Altman analysis, and intraclass correlation coefficient (ICC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Phantom experiments confirmed accurate slice displacements. Slice\u2010following was feasible in all subjects, yielding physiologically accurate mitral flow patterns. In healthy subjects, mitral and aortic stroke volumes agreed, with ICC = 0.72 and 0.90 for static and slice\u2010following planes; with bias \u00b11 SDs 23.2\u2009\u00b1\u200913.2 mls and 8.4\u2009\u00b1\u200910.8 mls, respectively. Agreement with planimetry was stronger, with ICC = 0.84 and 0.96; bias \u00b11 SDs 13.7\u2009\u00b1\u200913.7 mls and \u20132.0\u2009\u00b1\u20098.8 mls for static and slice\u2010following planes, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Conclusion<\/jats:title><jats:p>Slice\u2010following outperformed the conventional sequence and improved the accuracy of transmitral flow, which is important for assessment of diastolic function and mitral regurgitation.<\/jats:p><jats:p><jats:bold>Level of Evidence:<\/jats:bold> 2<\/jats:p><jats:p><jats:bold>Technical Efficacy:<\/jats:bold> Stage 2<\/jats:p><jats:p>J. Magn. Reson. Imaging 2020;51:1412\u20131421.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jmri.26971","type":"journal-article","created":{"date-parts":[[2019,10,26]],"date-time":"2019-10-26T03:44:59Z","timestamp":1572061499000},"page":"1412-1421","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Valvular imaging in the era of feature\u2010tracking: A slice\u2010following cardiac MR sequence to measure mitral flow"],"prefix":"10.1002","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3074-5380","authenticated-orcid":false,"given":"Felicia","family":"Seemann","sequence":"first","affiliation":[{"name":"Department of Clinical Sciences Lund, Clinical Physiology Lund University, Sk\u00e5ne University Hospital  Lund Sweden"},{"name":"Department of Biomedical Engineering, Faculty of Engineering Lund University  Lund Sweden"},{"name":"Department of Radiology &amp; Biomedical Imaging, Yale School of Medicine Yale University, New 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