J Korean Soc Radiol.  2019 Mar;80(2):239-258. 10.3348/jksr.2019.80.2.239.

Quantification of Hemodynamic Parameters Using Four-Dimensional Flow MRI

• Ha H
• Huh H
• Yang DH
• Kim N

• KMID: 2442516
• DOI: http://doi.org/10.3348/jksr.2019.80.2.239

Abstract

MRI provides non-invasive and non-ionizing methods for the accurate anatomic depiction of the cardiovascular system. Based on the inherent flow sensitivity, MRI can be used to investigate hemodynamic features in patients with anatomical data within a single measurement. In particular, time-resolved and three-dimensional (3D) characterization of blood flow using 4D flow MRI has achieved considerable progress in recent years. The present article reviews the principle and procedures of 4D Flow MRI. Various fluid dynamic biomarkers for possible clinical usage are also described, including wall shear stress, turbulent kinetic energy, and relative pressure. Finally, this article provides an overview of the clinical applications of 4D Flow MRI in various cardiovascular regions.

MeSH Terms

Biomarkers
Cardiovascular System
Heart
Hemodynamics*
Humans
Hydrodynamics
Magnetic Resonance Imaging*
Biomarkers

Figure

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  Fig. 1 Principles of 4D Flow MRI. 4D = four-dimensional Adapted from Ha et al. Korean J Radiol 2016;17:445-462, with premission of The Korean Society of Radiology (10).

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  Fig. 2 Velocity visualization and quantification of the flow rate.

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  Fig. 3 WSS estimation using four-dimensional phase contrast-MRI. WSS = wall shear stress Adapted from Ha et al. Korean J Radiol 2016;17:445-462, with permission of The Korean Society of Radiology (10).

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  Fig. 4 Principle of TKE estimation. IVSD = intravoxel velocity standard deviation, TKE = turbulent kinetic energy Adapted from Ha et al. Korean J Radiol 2016;17:445-462, with permission of The Korean Society of Radiology (10).

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  Fig. 5 Procedures for the estimation of the relative pressure field. Adapted from Ha et al. Korean J Radiol 2016;17:445-462, with permission of The Korean Society of Radiology (10).

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  Fig. 6 Streamline visualization of the aortic flow. Visualization of the aortic flow in a normal subject (A), patient with aortic stenosis (B), and patient with aortic regurgitation and aortic root dilatation at systole (C) and diastole (D). Note that aortic flow in aortic stenosis causes helical flow patterns; aortic flow in aortic dilatation causes impinging flow pattern during systole, and a substantial amount of regurgitation flow is observed. Adapted from Ha et al. Korean J Radiol 2016;17:445-462, with permission of The Korean Society of Radiology (10).

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  Fig. 7 Streamline visualization of a normal control and a patient. Comparison of patients with (A) normal and (B) replaced tissue-valve. Note that only the aortic blood flow with the replaced tissue-valve generates complex helical blood flow.

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  Fig. 8 Flow visualization of stenotic flow. Visualization of flow velocity (A) and TKE (B) in a patient with severe aortic stenosis. TKE = turbulent kinetic energy

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  Fig. 9 Visualization of vertical flow in an aortic sinus.

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