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Abdominal applications of quantitative 4D flow MRI

  • Special Section : Quantitative Imaging
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Abstract

4D flow MRI is a quantitative MRI technique that allows the comprehensive assessment of time-resolved hemodynamics and vascular anatomy over a 3-dimensional imaging volume. It effectively combines several advantages of invasive and non-invasive imaging modalities like ultrasound, angiography, and computed tomography in a single MRI acquisition and provides an unprecedented characterization of velocity fields acquired non-invasively in vivo. Functional and morphological imaging of the abdominal vasculature is especially challenging due to its complex and variable anatomy with a wide range of vessel calibers and flow velocities and the need for large volumetric coverage. Despite these challenges, 4D flow MRI is a promising diagnostic and prognostic tool as many pathologies in the abdomen are associated with changes of either hemodynamics or morphology of arteries, veins, or the portal venous system. In this review article, we will discuss technical aspects of the implementation of abdominal 4D flow MRI ranging from patient preparation and acquisition protocol over post-processing and quality control to final data analysis. In recent years, the range of applications for 4D flow in the abdomen has increased profoundly. Therefore, we will review potential clinical applications and address their clinical importance, relevant quantitative and qualitative parameters, and unmet challenges.

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Acknowledgements

The authors would like to thank Dr. Christopher Francois for providing us with images for Fig. 6 and Fig. 7.

Funding

This work was supported by the NIH (R01 DK096169, R01 DK125783, K24 DK102595). Dr. Oechtering receives funding from the German Research Foundation (OE 746/1-1). The authors acknowledge GE Healthcare who provides research support to the University of Wisconsin-Madison.

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Authors and Affiliations

  1. Department of Radiology, University of Wisconsin, 600 Highland Ave, Madison, WI, 53792, USA

    Thekla H. Oechtering, Nikolaos Panagiotopoulos, Oliver Wieben, Alejandro Roldán-Alzate & Scott B. Reeder

  2. Department of Radiology, Universität zu Lübeck, Lübeck, Germany

    Thekla H. Oechtering & Nikolaos Panagiotopoulos

  3. Department of Medical Physics, University of Wisconsin, Madison, WI, USA

    Grant S. Roberts, Oliver Wieben & Scott B. Reeder

  4. Department of Mechanical Engineering, University of Wisconsin, Madison, WI, USA

    Alejandro Roldán-Alzate & Scott B. Reeder

  5. Department of Biomedical Engineering, University of Wisconsin, Madison, WI, USA

    Alejandro Roldán-Alzate & Scott B. Reeder

  6. Department of Emergency Medicine, University of Wisconsin, Madison, WI, USA

    Scott B. Reeder

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  1. Thekla H. Oechtering
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All authors contributed to the study conception and design. Literature search and material collection were performed by THO and SBR. The first draft of the manuscript was written by THO and NP. All authors critically revised the manuscript and approved the final version.

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Correspondence to Thekla H. Oechtering.

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No authors have any relevant conflicts. Unrelated to this work, Dr. Reeder has ownership interests in Calimetrix, Reveal Pharmaceuticals, Cellectar Biosciences, Elucent Medical and HeartVista.

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Oechtering, T.H., Roberts, G.S., Panagiotopoulos, N. et al. Abdominal applications of quantitative 4D flow MRI. Abdom Radiol 47, 3229–3250 (2022). https://doi.org/10.1007/s00261-021-03352-w

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