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In vitro Assessment of Aortic Regurgitation Using Four-Dimensional Flow Magnetic Resonance Imaging
Published on: February 25, 2022
Novel Insights into Complex Cardiovascular Pathologies using 4D Flow Analysis by Cardiovascular Magnetic Resonance
Adam James Lewandowski1, Betty Raman2, Rajarshi Banerjee3
1Oxford Cardiovascular Clinical Research Facility, John Radcliffe Hospital, OX3 9DU. Oxford. United Kingdom.
Insights
Four-dimensional flow cardiovascular magnetic resonance (4D flow CMR) provides non-invasive blood flow assessment. This advanced imaging technique offers new insights into cardiovascular diseases and function.
Area of Science:
- Cardiovascular Imaging
- Medical Physics
- Biomedical Engineering
Background:
- Accurate blood flow assessment is crucial for understanding cardiovascular disease.
- Current imaging methods for blood flow quantification are often limited or invasive.
Purpose of the Study:
- To review the potential of four-dimensional velocity cardiovascular magnetic resonance (4D flow CMR) for non-invasive blood flow assessment.
- To highlight the applications and future directions of 4D flow CMR in cardiovascular research and clinical practice.
Main Methods:
- 4D flow CMR utilizes phase contrast imaging with flow encoding in three spatial dimensions and time.
- This technique allows for comprehensive assessment of blood flow dynamics throughout the cardiovascular system.
Main Results:
- 4D flow CMR enables non-invasive quantification of flow, pressure, velocity, wall shear stress, and turbulent kinetic energy.
- It provides novel insights into various cardiovascular pathologies, including cardiomyopathies and aortic diseases.
Conclusions:
- Standardization of 4D flow CMR acquisition and analysis is necessary for broader clinical adoption.
- Automated tools and standardized reporting will enhance capacity for large studies and clinical translation.
Background:
Blood flow assessment is essential to fully understand cardiovascular function in disease pathologies and for identification of individuals at long-term risk of cardiovascular disease development. Qualitative and quantitative assessments of blood flow by imaging modalities have been limited, and much of the accurate quantification has relied on invasive measures.
Methods:
This review discusses how four-dimensional velocity cardiovascular magnetic resonance (4D flow CMR) offers increasing potential for the non-invasive assessment of blood flow in the heart and major blood vessels such as the aorta. 4D flow CMR refers to phase contrast CMR with flow encoding in all three spatial directions that is resolved relative to all three dimensions of space and to the dimension of time throughout the cardiac cycle.
Results:
It has been demonstrated that 4D flow CMR can be used to assess parameters such as flow, pressure, velocity, wall shear stress and turbulent kinetic energy throughout the heart and major vessels of the cardiovascular system. It has been possible to gain new insights into cardiovascular pathologies such as, but not limited to, hypertrophic cardiomyopathy, dilated cardiomyopathy, Marfan syndrome and aortic bicuspid valve disease.
Conclusion:
Future work to standardize 4D flow CMR scan acquisition parameters is required. Furthermore, the development of automated analysis tools and standardized reporting of quantitative metrics are needed to increase capacity for larger studies and for translation to clinical practice. In doing so, the potential for 4D flow CMR to disentangle complex questions related to cardiovascular function will be maximized.
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