Table 1 Study list, analysis targets, applicability, validation methods, aims, study populations, main conclusions, and quantitative parameters

Nordmeyer et al. [11]

Venous & arterial flow pulmonary valve & AV flow

Highly clinically applicable

2D PC-CMR

2D vs nongated 4D vs gated 4D PC-CMR

Venous and arterial

Normal & CHD

34 ± 7

(n = 7, ♂3)

4D flow CMR is accurate in arterial, venous, and pathological flow

●

●

Van der Hulst et al. [26]

Pulmonary valve & tricuspid valve flow & RV diastolic function

Highly clinically applicable

2D PC-CMR & stroke volume

4D vs 2D PC-CMR

Pulmonary valve and tricuspid valve flow, RV diastolic function

Normal & rTOF

14 ± 2

(n = 19, ♂12)

4D flow CMR is accurate for assessing pulmonary valve forward and backward flow in patients with rTOF and healthy children. Superior to 2D PC-CMR for tricuspid flow

●

●

Geiger et al. [18]

Arterial flow and vortex visualisation

Potentially clinically applicable

None

Feasibility of

Vortex flow visualisation and retrospective flow quantification by 4D CMR

Normal & rTOF

26 ± 1(25–27)

(n = 4, ♂NS)

4D flow CMR analysis may provide valuable data on both intracardiac

and pulmonary vascular flow

●

●

●

●

Hsiao et al. [10]

Systemic & pulmonary flow

Highly clinically applicable

2D PC-CMR

2D PC CMR vs 4D CMR

CHD patients

–

4D flow CMR has higher consistency than 2D PC-CMR

●

Hsiao et al. [42]

Valves and shunts

Highly clinically applicable

Echo

The potential of PICS 4D flow and specialized imaging software in valvular insufficiency and intracardiac shunts

CHD patients

–

PICS 4D flow CMR is sufficient in identification of intracardiac shunting and haemodynamically significant valve regurgitation

●

●

Hsiao et al. [9]

Ventricular volumes and flow

Potentially clinically applicable

2D PC-CMR & stroke volume

Accelerated 4D PC CMR vs 2D PC CMR

flow and volume measurements

CHD patients

–

PICS 4D flow CMR is accurate for ventricular volumetry and flow

●

●

●

François et al. [19]

Arterial pulmonary flow and vortex

Potentially clinically applicable

None

Feasibility of

4D flow (VIPR) in flow visualisation and retrospective flow quantification by 4D CMR

Normal & rTOF

34 ± 13 (21–54)

(n = 10, ♂6)

VIPR 4D flow CMR is feasible. Analysis of types of TOF repair using 4D flow will be necessary in outcome prediction

●

●

●

●

Tariq et al. [20]

Venous & arterial flow quantification pulmonary valve & AV flow

Potentially clinically applicable

None

Evaluate the precision and accuracy of PICS 4D venous and arterial flow quantification

CHD patients

–

PICS 4D flow CMR is accurate for venous flow quantification

●

●

Nordmeyer et al. [27]

Arterial flow and valves

Highly clinically applicable

2D PC-CMR

& Echo

4D flow vs 2D PC-CMR

Valve stenosis and flow

Normal, valve stenosis

34 ± 7

(n = 7,♂3)

4D flow CMR improves quantification accuracy of peak flow velocities in semilunar valve stenosis

●

●

Giese et al. [22]

Arterial and pulmonary flows, volumes and vortex

Potentially clinically applicable

2D CMR

k-t PCA 4D flow vs 2D PC-CMR

flow and volume measurements

Normal, CHD patients

23–40

(n = 10, ♂NS)

k-t PCA 4D flow CMR is feasibile in CHD

●

●

●

Jeong et al. [36]

Ventricular kinetic energy

Highly clinically applicable

None

Ventricular kinetic energy

with 4D flow

Normal and rTOF

39 ± 15

(n = 9, ♂6)

VIPR 4D flow CMR kinetic energy is a novel non-invasive method

of monitoring cardiac efficiency

●

●

Hsiao et al. [28]

Valvular flow

Highly clinically applicable

2D CMR

Feasibility of PICS 4D flow for RF and valve flow

CHD patients

–

PICS 4D flow CMR with valve tracking is accurate for valvular flow and RF

●

●

●

Gabbour et al. [21]

Arterial Peak velocities and

stroke volumes

Potentially clinically applicable

2D PC-CMR & Echo

4D vs 2D PC-CMR and Echo

Aortic and pulmonary flow and volume measurements

CHD patients

–

4D flow CMR is a clinical alternative to 2D PC-CMR in

children and young adults

●

●

●

●

Hirtlir et al. [12]

Arterial and pulmonary flows, volumes and vorticity

Highly clinically applicable

None

Analysis of flow and vorticity in the right heart by 4D flow

Normal & rTOF

23 ± 2

(21–26)

(n = 12, ♂7)

Quantitative intracardiac vorticity in rTOF patients can be correlated with flow and volumes

●

●

●

Hanneman et al. [29]

Ventricular volumes and flow

Highly clinically applicable

bSSFP

4D flow with ferumoxytol for volume and mass

CHD patients

–

4D flow CMR with ferumoxytol enables accurate evaluation of mass and volume as well as flow in a single acquisition

●

Chelu et al. [30]

Pulmonary flow

Highly clinically applicable

2D PC-CMR

Evaluate a cloud-based platform for 4D flow analysis

Quantify forward flow, regurgitation, and peak systolic velocity over the pulmonary artery

CHD patients

–

Bulk flow and pulmonary regurgitation can be accurately quantified using 4D flow CMR analysed with a cloud based application

●

●

●

Hussaini et al. [37]

Ventricular kinetic energy

Highly clinically applicable

None

Time-resolved versus time-averaged ventricular segmentation on

4D CMR kinetic energy calculations

CHD patients

27 ± 2

(24–31)

(n = 10, ♂6)

Time averaged segmentation is more efficient but overestimates time resolved values

●

●

Fredriksson et al. [31]

Ventricular kinetic energy

Highly clinically applicable

None

RV turbulent kinetic energy & relationship with RV remodelling

Normal & rTOF

31 ± 11 (22–54)

(n = 10,♂NS)

Total KE in the RV of patients with rTOF increases with RV volumes and regurgitant fraction

●

●

Driessen et al. [23]

Tricuspid valvular flow

Highly clinically applicable

2D PC-CMR & echo

2D vs 4D flow vs Echo for tricuspid valve flow and regurgitation

CHD, pulmonary hypertension & normal

41 ± 11

(n = 21,♂14)

4D flow CMR shows good agreement to 2D PC-CMR. 38% had different grading to echo

●

●

Sjoberg et al. [33]

Ventricular kinetic energy

Highly clinically applicable

None

RV and LV kinetic energy

Normal & rTOF

30 ± 7

(n = 14, ♂12)

RV Total KE higher in rTOF and highest in restrictive physiology

●

●

●

Sjoberg et al. [32]

Haemodynamic forces

Highly clinically applicable

None

Ventricular haemodynamic forces

Normal & rTOF

31 ± 7

(n = 15, ♂10)

Differences in forces versus control subjects remain after pulmonary

valve replacement

●

●

Robinson et al. [34]

Ventricular kinetic energy

Highly clinically applicable

None

RV turbulent kinetic energy relationship with RV remodelling

Normal & rTOF

16 ± 3

(n = 24, ♂11)

Total KE in the RV of patients with rTOF increases with RV volume and regurgitant fraction

●

●

●

Lee et al. [58]

Aortic flow

Highly clinically applicable

None

Flow in the ascending aorta and relationship with aortic dilatation

Normal & rTOF

34 ± 9

(n = 11, ♂10)

Aortic dilatation, wall shear stress and flow jet angle changed in rTOF patients

●

Isorni et al. [25]

Pulmonary and aortic flow

Highly clinically applicable

2D PC-CMR

Pulmonary and aortic flow

Normal & rTOF

NS (n = 10, ♂NS)

4D flow CMR is feasible and more consistent pulmonary vs aortic flow in rTOF

●

●

●

●

Jacobs et al. [24]

Ventricular volumes and flow

Highly clinically applicable

2D PC-CMR

2D vs 4D CMR

rTOF

–

4D flow CMR with gadobenate dimeglumine accurate for flow and volumes

●

●

●

●

●

Schafer et al. [35]

Aortic flow and vorticity

Highly clinically applicable

Aortic flow and LV vorticity

Normal & rTOF

10 ± 2

(n = 10, ♂6)

●

●