Skip to main content

Table 1 Recommended 4D Flow CMR analysis for different clinical indications - all aspects below can be derived from a single acquisition. For a comprehensive overview of 4D Flow CMR quantification and visualization methodology including additional references please see recently published review articles [113118]

From: 4D flow cardiovascular magnetic resonance consensus statement

Clinical indication Quantification Visualizationa
Heart valve disease (stenosis, regurgitation) Flow volume • Identification of regurgitant and stenotic jets using streamlines and pathlines
• Regurgitant flow volumes & fraction • Peak velocity location by systolic streamlines or maximum intensity projections of speed images
Peak velocity • Outflow patterns using streamlines
• Estimated pressure gradients with modified Bernoulli equation • Time course of flow curve
Shunts and collateral vessels (Ventricular-septal defect, atrial-septal defect, fistulae) Flow volume • Identification of shunt flow and flow directionality using pathlines
• Shunt flow volume
• Qp/Qs
Complex congenital heart disease (e.g. single ventricle physiology, Fontan circulation, Fallot’s tetralogy), Flow volume • Flow directionality using pathlines
• Regurgitant flow volumes & fraction • Shunt flow using pathlines
• Flow distribution (e.g. left vs right pulmonary artery, relative SVC/IVC flow) • Flow connectivity and distribution using pathlines
• Collateral flow volume
Peak velocity
Aortic disease (aneurysm, coarctation, dissection) Flow volume • Peak velocity location by systolic streamlines or maximum intensity projections of speed images
• Regurgitant flow volumes & fraction • Identification of flow in false lumen and potential entry/exit sites
• Relative flows in true & false lumen • Identification of highly disrupted flow patterns (likely to reduce forward flow) in tortuous aortic conditions
Peak velocity
  1. aThe amount of supporting literature is smaller for visualization compared to quantification