4.5 Review

The role of 4D flow MRI for clinical applications in cardiovascular disease: current status and future perspectives

Journal

QUANTITATIVE IMAGING IN MEDICINE AND SURGERY
Volume 11, Issue 9, Pages 4193-4210

Publisher

AME PUBL CO
DOI: 10.21037/qims-20-1234

Keywords

Magnetic resonance imaging (MRI); cardiovascular system; hemodynamics

Funding

  1. National Natural Science Foundation of China [81771811, 81971588]
  2. Construction Research Project of Key Laboratory (Cultivation) of the Chinese Academy of Medical Sciences [2019PT310025]
  3. Clinical and Translational Fund of the Chinese Academy of Medical Sciences [2019XK320063]
  4. Capital's Funds for Health Improvement and Research [CFH 2020-2-4034]
  5. Capital Clinically Characteristic Applied Research Fund [Z191100006619021]

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4D flow MRI utilizes blood flow encoding in three directions to comprehensively and accurately quantify and visualize hemodynamic parameters. It is widely used in various parts of the body and plays a crucial role in modern clinical practice.
Magnetic resonance imaging (MRI) four-dimensional (4D) flow is a type of phase-contrast (PC) MRI that uses blood flow encoded in 3 directions, which is resolved relative to 3 spatial and temporal dimensions of cardiac circulation. It can be used to simultaneously quantify and visualize hemodynamics or morphology disorders. 4D flow MRI is more comprehensive and accurate than two-dimensional (2D) PC MRI and echocardiography. 4D flow MRI provides numerous hemodynamic parameters that are not limited to the basic 2D parameters, including wall shear stress (WSS), pulse wave velocity (PWV), kinetic energy, turbulent kinetic energy (TKE), pressure gradient, and flow component analysis. 4D flow MRI is widely used to image many parts of the body, such as the neck, brain, and liver, and has a wide application spectrum to cardiac diseases and large vessels. This present review aims to summarize the hemodynamic parameters of 4D flow MRI technology and generalize their usefulness in clinical practice in relation to the cardiovascular system. In addition, we note the improvements that have been made to 4D flow MRI with the application of new technologies. The application of new technologies can improve the speed of 4D flow, which would benefit clinical applications.

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