Background:
Cardiovascular flow is commonly assessed with two-dimensional, phase contrast (2D PC-MRI). However, scan prescription and acquisition over multiple planes is lengthy, often requires direct physician oversight, and has inconsistent results. Time-resolved volumetric PC-MRI (4D flow) may address these limitations.
Objective:
We assess the degree of agreement and internal consistency between 2D and 4D flow quantification in our clinical population.
Method:
Software enabling flow calculation from 4D flow was developed in Java. With IRB approval and HIPAA compliance, eighteen consecutive patients without shunts were identified who underwent both (a) conventional 2D PC-MRI of the aorta and main pulmonary artery and (b) 4D flow imaging. Aortic and pulmonary flow rates were assessed with both techniques.
Results:
Both methods showed general agreement in flow rates (ρ: 0.87-0.90). Systemic and pulmonary arterial flow rates were well-correlated (ρ: 4D 0.98-0.99, 2D 0.93), but more closely matched with 4D (p<0.05, Brown-Forsythe). Pulmonary flow rates were lower than systemic rates for 2D (p<0.05, two-sample t-test). In a sub-analysis of patients without pulmonary or aortic regurgitation, 2D showed improved correlation of flow rates while 4D phase-contrast remained tightly correlated (ρ: 4D 0.99-1.00, 2D 0.99).
Conclusion:
4D PC-MRI demonstrates greater consistency than conventional 2D PC-MRI for flow quantification.