A Comprehensive Review of 4D Flow MRI and CFD in Cardiovascular and Congenital Heart Disease

A growing population of adults with congenital heart disease (CHD) has spurred increased study in recent decades into the complex anatomical vasculature of congenital heart patients and the resulting hemodynamic changes that progressively affect the heart and great vessels. To this end, assessment of flow dynamics using advanced imaging technology and computational simulations have paved a path toward greater understanding of the patterns and implications of flow alterations in complex and changing vasculature, and offer promise for diagnostic and therapeutic intervention in the future. The focus of this review is to describe past studies of four-dimensional (4D) magnetic resonance imaging (MRI) and computational fluid dynamics (CFD) in the literature as related to pathophysiology of the heart in structural and CHD. This review will highlight the importance of working with both imaging and simulation technology to co-validate experimental (4D MRI) and simulation (CFD) models, allowing for more accurate depiction of flow dynamics within human vasculature and ultimately toward improvement of the tools and methodologies used in analysis, simulation and prediction of cardiovascular hemodynamics toward enhanced diagnostics and therapeutic intervention.