Gabbert Dominik Daniel, Uebing Anselm Sebastian, Voges Inga
Department of Congenital Heart Disease and Pediatric Cardiology, University Hospital Schleswig-Holstein, 24105 Kiel, Germany.
DZHK (German Centre for Cardiovascular Research), Partner Site Hamburg/Greifswald/Kiel/Lübeck, 24105 Kiel, Germany.
J Clin Med. 2025 May 29;14(11):3801. doi: 10.3390/jcm14113801.
Staged palliation with the creation of a Fontan circulation is the standard surgical approach in patients with a single ventricle. The Fontan circulation is a complex circuit that is associated with various complications that may present early or later in life and can limit life quality and expectancy. In this context, a good understanding of the Fontan physiology is important to improve outcomes for single-ventricle patients. Cardiovascular magnetic resonance (CMR) is recommended for the long-term follow-up of Fontan patients, as it provides functional and haemodynamic information. Four-dimensional (4D) Flow MRI is a time-resolved, three-dimensional, velocity-encoded cardiovascular magnetic resonance technique that is increasingly used in Fontan patients because it not only enables measuring blood flow within a three-dimensional (3D) volume, but also allows for assessing more advanced haemodynamic parameters that may help in understanding the Fontan physiology and pathophysiology. Furthermore, 4D Flow is used for image-based simulations using computational fluid dynamics. In this review, we provide an overview of the use of cardiovascular magnetic resonance flow assessment, with a focus on four-dimensional flow ('4D Flow').
对于单心室患者，分期姑息性手术建立Fontan循环是标准的手术方法。Fontan循环是一个复杂的循环系统，与各种并发症相关，这些并发症可能在生命早期或晚期出现，并可能限制生活质量和预期寿命。在这种情况下，深入了解Fontan生理学对于改善单心室患者的治疗效果至关重要。心血管磁共振（CMR）被推荐用于Fontan患者的长期随访，因为它能提供功能和血流动力学信息。四维（4D）流MRI是一种时间分辨的三维速度编码心血管磁共振技术，越来越多地用于Fontan患者，因为它不仅能够测量三维（3D）容积内的血流，还能评估更高级的血流动力学参数，这可能有助于理解Fontan生理学和病理生理学。此外，4D流用于基于图像的计算流体动力学模拟。在这篇综述中，我们概述了心血管磁共振血流评估的应用，重点是四维流（“4D流”）。
