Whole heart non-contrast 4D Flow MRI at 3.0T for clinical follow-up of congenital heart disease in children and adolescents.

Authors

J van Schuppen, A E van der Hulst, R A P Takx, M Groenink, S D Haas, J Oosterlaan, N A Blom, J J Splinter, I M Kuipers, J L Nelissen, J M den Harder, E M Schrauben, R N Planken, P van Ooij

Published in

Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance. Pages 102786. Aug 14, 2026. Epub Aug 14, 2026.

Abstract

Cardiac MRI is central to evaluating ventricular function and hemodynamics in pediatric congenital heart disease (CHD). Conventional two-dimensional phase-contrast (2D-PC) imaging is challenged by fixed planes, operator dependence, and multiple breath-holds, where four-dimensional flow (4DF) MRI overcomes these challenges. This study compares accelerated whole heart 4D Flow (WH-4DF) MRI with 2D-PC and volumetric measurements in routine clinical follow up of pediatric CHD and highlights its applicability.
For this prospective study seventy-one consecutive pediatric patients (median age 14 ± 2.4 years; 49 male) with surgically corrected CHD underwent both 2D-PC and accelerated WH-4DF MRI. Planning and acquisition times and overall success rate were recorded. Flow, velocity and volumetric measurements were compared using Bland-Altman analysis, orthogonal regression, and intraclass correlation coefficients. WH-4DF showed excellent agreement with 2D-PC and short-axis volumetry for aortic, pulmonary, and ventricular stroke volumes (mean differences <5%). Mean planning and acquisition time for WH-4DF was 10.3minutes (SD 1.1), where planning and acquisition time of 2D-PC was 11.2minutes (SD 6.25). Aliasing was observed in 11% of the WH-4DF acquisitions but did not compromise interpretability.
Accelerated WH-4DF MRI is clinically robust and broadly applicable across CHD, including complex postoperative anatomies. It provides comparable numbers to 2D-PC, reproducible, and time-efficient flow quantification with superior coverage and reduced operator dependence. A single WH-4DF scan can replace multiple 2D-PC acquisitions with comparable results and may enhance assessment of regurgitant flow. These features underscore its potential role in routine clinical practice and in advancing our understanding of disease processes.

PMID:
42600991
Bibliographic data and abstract were imported from PubMed on 15 Aug 2026.

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