Department of Radiology, University of Wisconsin, 600 Highland Ave, Madison, WI, 53792, USA.
Department of Radiology, Universität zu Lübeck, Lübeck, Germany.
Abdom Radiol (NY). 2022 Sep;47(9):3229-3250. doi: 10.1007/s00261-021-03352-w. Epub 2021 Nov 27.
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.
4D 流 MRI 是一种定量 MRI 技术,可在三维成像容积上全面评估时变血流动力学和血管解剖结构。它有效地将超声、血管造影和计算机断层扫描等多种有创和无创成像方式的优势结合在单次 MRI 采集过程中,并提供了对体内非侵入性获得的速度场的前所未有的描述。由于腹部血管的解剖结构复杂且多变,存在广泛的血管口径和血流速度,需要进行大容量覆盖,因此对腹部血管进行功能和形态成像极具挑战性。尽管存在这些挑战,但 4D 流 MRI 作为一种有前途的诊断和预后工具,因为腹部的许多病变都与动脉、静脉或门静脉系统的血流动力学或形态变化有关。在这篇综述文章中,我们将讨论腹部 4D 流 MRI 的实施技术方面,从患者准备和采集方案到后处理和质量控制再到最终数据分析。近年来,4D 流在腹部的应用范围有了显著的增加。因此,我们将回顾潜在的临床应用,并探讨其临床重要性、相关的定量和定性参数以及未满足的挑战。