Related Experiment Video
Updated: Jun 24, 2026
Human Fetal Blood Flow Quantification with Magnetic Resonance Imaging and Motion Compensation
Published on: January 7, 2021
4D Flow MRI Quantification of Congenital Shunts: Comparison to Invasive Catheterization
Michael J Horowitz1, Daniel F Kupsky1, Howaida G El-Said1
1Department of Radiology, UC San Diego Medical Center, 200 W Arbor Dr, San Diego, CA 92103 (M.J.H., S.J.K., A.H.); Division of Cardiology (D.F.K., L.A.) and Department of Pediatrics, Division of Cardiology (H.G.E.), UC San Diego, La Jolla, Calif; and Division of Cardiology, UC Los Angeles Health, Los Angeles, Calif (D.F.K.).
Purpose:
To compare invasive right heart catheterization with four-dimensional (4D) flow MRI for estimating shunt fraction in patients with intracardiac and extracardiac shunts.
Materials And Methods:
In this retrospective study, patients who underwent 4D flow MRI and invasive right heart catheterization with a shunt run between August 2015 and November 2018 were included. The primary objective was comparison of estimated shunt fraction (ratio of pulmonary-to-systemic flow, Qp/Qs) at 4D flow and catheterization. Secondary objectives included comparison of the right ventricular-to-left ventricular stroke volume ratio (RVSV/LVSV) to shunt fraction (for those with applicable shunts) and comparison of cardiac output between 4D flow and catheterization. Statistical analysis included Pearson correlation and Bland-Altman plots.
Results:
A total of 33 patients met inclusion criteria (mean age, 49 years ± 16 [standard deviation]; 24 women). 4D flow measurements of Qp/Qs strongly correlated with those at catheterization (r = 0.938), and there was no bias. RVSV/LVSV correlated strongly with Qp/Qs from 4D flow (r = 0.852) and catheterization (r = 0.842). Measurements of left ventricle (Qs) and right ventricle (QP) cardiac output from 4D flow and catheterization (Fick) correlated moderately overall (r = 0.673 [Qp] and r = 0.750 [Qs]).
Conclusion:
Shunt fraction measurement using 4D flow MRI compares well with that using invasive cardiac catheterization.Supplemental material is available for this article.© RSNA, 2021.
