Clinical applications of four-dimensional flow magnetic resonance imaging

Abstract

Four-dimensional flow magnetic resonance imaging (MRI) is a time-resolved three-dimensional phase-contrast technique. It provides volumetric information for the cardiovascular system of interest through blood flow velocity mapping in three spatial dimensions throughout the cardiac cycle. The technological advances of MRI over the last two decades have facilitated its transition from the experimental environment into clinical practice, thereby enabling the non-invasive in vivo assessment of haemodynamics across various vascular territories of the human body. This article endeavours to elucidate its inception and fundamental technical principles, to delineate its main clinical indications—particularly in the cardiothoracic domain—, and to review its limitations and future directions. The ongoing evolution of this diagnostic modality continues to develop further understanding of the interplay between abnormal haemodynamics and cardiovascular pathologies, promising enhanced clinical value.