• Ciaran Grafton-Clarke, Liandra Ramachenderam, Gareth Matthews, Jordi Broncano, and Pankaj Garg.
• Norwich Medical School, University of East Anglia, Norwich, UK.
• Brit J Hosp Med. 2024 Nov 30; 85 (11): 1181-18.

AbstractThis review describes the evolution and enhanced diagnostic capabilities introduced by four-dimensional (4D) flow cardiac magnetic resonance (CMR) in cardiovascular imaging. It charts the historical advancements from echocardiography through to two-dimensional phase-contrast magnetic resonance imaging (2D-PC MRI), culminating in the adoption of 4D flow MRI. This technique affords exhaustive, time-resolved, three-dimensional visualisations of intracardiac and vascular blood flow, refining the accuracy of cardiovascular assessments over traditional methods, especially in complex anatomical settings. The review elaborates on the capacity of 4D flow MRI to offer unparalleled insights into flow dynamics, vessel wall interactions, and cardiac function, thereby enhancing disease detection, risk stratification, and therapeutic evaluations. It accentuates the impact of 4D flow MRI on modern cardiological practices, highlighting its pivotal role in advancing diagnostics and patient management in the context of diverse cardiovascular pathologies.

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