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Review
. 2024 Nov 14.
doi: 10.1007/s00247-024-06093-2. Online ahead of print.

Going with the flow: Implementing a 4D flow MRI program at a children's hospital

Aparna Sodhi  1 , Nicholas K Brown  2 , Joshua D Robinson  3   4   5 , Andrada R Popescu  6   4 , Michael Markl  4   7 , Cynthia K Rigsby  6   4   5
Affiliations
Review

Going with the flow: Implementing a 4D flow MRI program at a children's hospital

Aparna Sodhi et al. Pediatr Radiol. .

Abstract

Four-dimensional phase contrast MRI (4D flow) has emerged as a versatile imaging technique for comprehensive visualization and both qualitative and quantitative assessment of cardiovascular blood flow. 4D flow is a three-dimensional, time-resolved acquisition that is gated to the cardiac cycle. 4D flow provides cardiovascular velocity and flow assessment across the volume of acquisition and yields a multitude of advanced hemodynamic parameters that help to assess the impact of cardiovascular disease on flow and vice versa, guiding the clinical and surgical management of patients with congenital and acquired heart disease. In the past, lengthy scan acquisition and complex post-processing workflows hindered 4D flow adoption into routine clinical practice. Decreasing image acquisition times and improvements in post-processing techniques have made 4D flow a clinically useful tool. The purpose of this communication is to facilitate more widespread adoption of 4D flow by describing its clinical utility, technical acquisition, optimization, and post-processing in pediatric cardiovascular imaging at our center.

Keywords: Cardiovascular; Congenital heart disease; Flow visualization; Four-dimensional flow (4D flow); Hemodynamics; Magnetic resonance imaging; Pediatrics.

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Conflict of interest statement

Declarations Competing interests The authors declare no competing interests.

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References

    1. Hoffman JL, Kaplan S (2002) The incidence of congenital heart disease. J Am Coll Cardiol. 39:1890–1900 - PubMed - DOI
    1. Oster M, Lee K, Honein M et al (2013) Temporal trends in survival for infants with critical congenital heart defects. Pediatrics 131:e1502–e1508 - PubMed - DOI
    1. Vasanawala SS, Hanneman K, Alley MT, Hsiao A (2015) Congenital heart disease assessment with 4D flow MRI. J Magn Reson Imaging 42:870–886 - PubMed - DOI
    1. Alphonso N, Angelini A, Barron DJ et al (2020) Guidelines for the management of neonates and infants with hypoplastic left heart syndrome: the European Association for Cardio-Thoracic Surgery (EACTS) and the Association for European Pediatric and Congenital Cardiology (AEPC) hypoplastic left heart syndrome guidelines task force. Eur J Cardiothorac Surg 58:416-499
    1. Hsiao A, Yousaf U, Alley MT et al (2015) Improved quantification and mapping of anomalous pulmonary venous flow with four-dimensional phase-contrast MRI and interactive streamline rendering. J Magn Reson Imaging 42:1765–1776 - PubMed - PMC - DOI

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