Clinical Applications of MRA 4D-Flow

  • Lilia M. Sierra-GalanEmail author
  • Christopher J. François
Imaging (Q Truong, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Imaging


Purpose of review

Four-dimensional (4D)-Flow cardiovascular magnetic resonance (CMR) is three-dimensional, time-resolved, three-directional velocity-encoded magnetic resonance that provides flow velocity data within a volumetric region across the cardiac cycle (CC). The goals of this paper are to review the current clinical applications of this technique; provide an overview of the general physics; discuss key points from the expert consensus document; and present recent advances in the field. The advantages and disadvantages of 4D-Flow CMR in comparison with the standard and gold standard methods are summarized.

Recent findings

4D-Flow CMR offers unique insights into cardiac and circulatory physiology with an ability to quantify advanced hemodynamic parameters in a variety of pathologic entities including aortic and pulmonary artery diseases, valvular heart disease, complex congenital heart disease, and extra-thoracic cardiovascular diseases. Recent large cohort studies highlight how it provides information that has clinical impact beyond a better understanding of the disease and that will permit better and more timely management and prognosis.


4D-Flow CMR provides unique qualitative and quantitative flow dynamics information and its impact on cardiac chambers, vessel walls, and myocardium. As scan acquisition and post-processing of 4D-Flow CMR become faster and simpler, the investigational and clinical opportunities will expand dramatically.


MRA 4D-Flow 4D Flow CMR Magnetic resonance Phase contrast Blood flow Aorta 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Supplementary material

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11936_2019_758_MOESM2_ESM.mp4 (927 kb)
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References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Lilia M. Sierra-Galan
    • 1
    Email author
  • Christopher J. François
    • 2
  1. 1.American British Cowdray Medical Center05300, Mexico CityMexico
  2. 2.School of Medicine and Public HealthUniversity of WisconsinMadisonUSA

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