Time-resolved phase contrast (PC) MRI with velocity encoding in three directions (flow-sensitive four-dimensional MRI) can be employed to assess three-dimensional blood flow in the entire aortic lumen within a single measurement. These data can be used not only for the visualization of blood flow but also to derive additional information on vascular geometry with three-dimensional PC MR angiography (MRA). As PC-MRA is sensitive to available signal-to-noise ratio, standard and novel blood pool contrast agents may help to enhance PC-MRA image quality. In a group of 30 healthy volunteers, the influence of different contrast agents on vascular signalto-noise ratio, PC-MRA quality, and subsequent three-dimensional stream-line visualization in the thoracic aorta was determined. Flow-sensitive four-dimensional MRI data acquired with contrast agent provided significantly improved signal-to-noise ratio in magnitude data and noise reduction in velocity data compared to measurements without contrast media. The agreement of three-dimensional PC-MRA with reference standard contrast-enhanced MRA was good for both contrast agents, with improved PC-MRA performance for blood pool contrast agent, particularly for the smaller supraaortic branches. While most clinical applications of MRA rely on the application of Gadolinium (Gd) contrast agent (CA), three-dimensional (3D) phase contrast (PC)-MRA based on velocity-encoded 3D MRI with encoding in three directions has proven to be a useful alternative (8-11). PC-MRA can provide detailed information on vascular geometry and may offer additional information on flow direction. However, most PC-MRA implementations used nongated data acquisition, which can result in artifacts for pulsatile blood flow. Further drawbacks of the PC-MRA method are long scan times and lack of respiration control, which limited most applications of 3D PC-MRA to static regions with low pulsatile flow such as the cranial vessels (12,13).Recently, improved time-resolved (CINE) 3D PC MRI techniques using electrocardiography (ECG) gating and advanced navigator respiration control (flow-sensitive four-dimensional [4D] MRI) have been successfully applied for the analysis of pulsatile 3D blood flow in the aorta (14-24). Such techniques offer the opportunity for the detailed analysis of pulsatile 3D blood flow but require scan times up to 20 min. We previously reported an approach to derive 3D angiographic information (3D PC-MRA) from flow-sensitive 4D MRI (24,25). We showed that it was possible to exploit the information in the acquired flow-sensitive 4D data to derive angiographic information without performing additional MRA measurements. Although the derived 3D PC-MRA does not provide the same detailed depiction of anatomy and morphology compared to CE-MRA, it can improve considerably the presentation of the results by combining 3D visualization of anatomy and flow for large vascular geometries such as the thoracic aorta.Based on this strategy, an improved data processing workflow including noise masking was impleme...