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Updated: Dec 13, 2025

In vitro Assessment of Aortic Regurgitation Using Four-Dimensional Flow Magnetic Resonance Imaging
Published on: February 25, 2022
4D Flow Vorticity Visualization Predicts Regions of Quantitative Flow Inconsistency for Optimal Blood Flow
Francisco J Contijoch1, Michael Horowitz1, Evan Masutani1
1Department of Bioengineering, Jacobs School of Engineering (F.J.C.) and Department of Radiology, School of Medicine (F.J.C., M.H., E.M., S.K., A.H.), UC San Diego, 9500 Gilman Dr, MC0412, La Jolla, CA 92093-0412.
Purpose:
To evaluate whether automated vorticity mapping four-dimensional (4D) flow MRI can identify regions of quantitative flow inconsistency.
Materials And Methods:
In this retrospective study, 35 consecutive patients who underwent MR angiography with 4D flow MRI at 3.0 T from December 2017 to October 2018 were analyzed using a λ 2-based technique for vorticity visualization and quantification. The patients were aged 58.6 years ± 14.4 (standard deviation), 12 were women, 18 had ascending aortic aneurysms (maximal diameter > 4.0 cm), and 10 had bicuspid aortic valves. Flow measurements were made in the ascending aorta (aAo), mid-descending aorta, main pulmonary artery, and superior vena cava. Statistical tests included t tests and F tests with a type I error threshold (α) of .05.
Results:
The 35 patients were visually classified as having no (n = 9), mild (n = 8), moderate (n = 11), or severe vorticity (n = 7). Across all patients, standard deviation of cardiac output in the aAo (0.58 L/min ± 0.45) was significantly (P < .001) higher than in the pulmonary arteries (0.15 L/min ± 0.10) and descending aorta and superior vena cava (0.14 L/min ± 0.12). The standard deviation of cardiac output observed in the aAo was significantly greater (P < .01) in patients with moderate or severe vorticity (0.73 L/min ± 0.55) than in those with none or mild vorticity (0.44 L/min ± 0.26).
Conclusion:
Cardiac output and blood flow are essential MRI measurements in the evaluation of structural heart disease. Vorticity visualization may be used to help guide optimal location for flow quantification.© RSNA, 2020See also the commentary by Markl in this issue.
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