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Updated: Nov 11, 2025
Human Fetal Blood Flow Quantification with Magnetic Resonance Imaging and Motion Compensation
Published on: January 7, 2021
Reduced scan time and superior image quality with 3D flow MRI compared to 4D flow MRI for hemodynamic evaluation of
Friso M Rijnberg1, Hans C van Assen2, Joe F Juffermans2
1Department of Cardiothoracic Surgery, Leiden University Medical Center, Albinusdreef 2, 2333ZA, Leiden, The Netherlands. f.m.rijnberg@lumc.nl.
Insights
Non-ECG gated 3D flow MRI significantly reduces scan times for Fontan patients. This method accurately assesses Fontan pathway hemodynamics, offering improved image quality compared to 4D flow MRI.
Area of Science:
- Cardiovascular Imaging
- Medical Physics
Background:
- 4D flow MRI in Fontan patients is limited by long scan times.
- Pulsatility in the Fontan pathway is minimal, suggesting potential for non-ECG gated techniques.
Purpose of the Study:
- To evaluate the feasibility of non-gated 3D flow MRI for assessing Fontan pathway hemodynamics.
- To compare scan time, image quality, and clinical parameter accuracy of 3D flow MRI against 2D and 4D flow MRI.
Main Methods:
- Prospective study of 32 Fontan patients undergoing 2D, 3D, and 4D flow MRI.
- Assessment of time-averaged flow rates, including right-to-left pulmonary flow distribution and systemic-to-pulmonary collateral flow (SPCF).
Main Results:
- 3D flow MRI achieved a tenfold reduction in scan time compared to 4D flow MRI (1.6 min vs. 15.9 min).
- Superior signal-to-noise ratio and vessel sharpness were observed with 3D flow MRI.
- Good-excellent agreement was found between 3D flow MRI and reference methods (2D/4D flow) for key hemodynamic parameters.
Conclusions:
- Non-gated 3D flow MRI is a viable alternative for Fontan pathway assessment.
- This technique offers significant reductions in scan time and improved image quality without compromising diagnostic accuracy.
Abstract:
Long scan times prohibit a widespread clinical applicability of 4D flow MRI in Fontan patients. As pulsatility in the Fontan pathway is minimal during the cardiac cycle, acquiring non-ECG gated 3D flow MRI may result in a reduction of scan time while accurately obtaining time-averaged clinical parameters in comparison with 2D and 4D flow MRI. Thirty-two Fontan patients prospectively underwent 2D (reference), 3D and 4D flow MRI of the Fontan pathway. Multiple clinical parameters were assessed from time-averaged flow rates, including the right-to-left pulmonary flow distribution (main endpoint) and systemic-to-pulmonary collateral flow (SPCF). A ten-fold reduction in scan time was achieved [4D flow 15.9 min (SD 2.7 min) and 3D flow 1.6 min (SD 7.8 s), p < 0.001] with a superior signal-to-noise ratio [mean ratio of SNRs 1.7 (0.8), p < 0.001] and vessel sharpness [mean ratio 1.2 (0.4), p = 0.01] with 3D flow. Compared to 2D flow, good-excellent agreement was shown for mean flow rates (ICC 0.82-0.96) and right-to-left pulmonary flow distribution (ICC 0.97). SPCF derived from 3D flow showed good agreement with that from 4D flow (ICC 0.86). 3D flow MRI allows for obtaining time-averaged flow rates and derived clinical parameters in the Fontan pathway with good-excellent agreement with 2D and 4D flow, but with a tenfold reduction in scan time and significantly improved image quality compared to 4D flow.
