ArticlePediatric radiology2026
Establishing the reliability of non-contrast 4D flow in congenital heart disease at 1.5T.
Article in Pediatric radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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8 authors.
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Abstract
background4D flow has been shown to correlate well with 2D phase-contrast (2D PC) flow measurements, although most of the current literature is based on post-contrast imaging.
objectiveGiven recent interest in non-contrast techniques, we hypothesized that non-contrast 4D flow (NC 4D Flow) would correlate well with 2D PC and ventricular stroke volumes. METHODS AND MATERIALS: A prospective cohort of pediatric and young adult patients with suspected/confirmed congenital heart disease (CHD) underwent cardiac MRI at 1.5T with acquisition of NC 4D Flow and 2D PC. Pearson correlation, linear mixed-effect correlations, and Bland-Altman comparisons were performed to compare these methods with secondary analyses of internal consistency and image quality/noise.
resultsIn our cohort of 30 patients (age, 8-20 years), NC 4D Flow correlated strongly with 2D PC for net flow (r=0.76), peak velocity (r=0.9, P<0.001), and regurgitant fraction (r=0.75, P<0.001). By Bland-Altman comparison, NC 4D Flow was 10.1% lower for net flows and 18.9% higher for peak velocity compared to 2D PC. NC 4D Flow also slightly underestimated ventricular stroke volumes (18.1% lower for ascending aorta vs. left ventricular stroke volume and 13.9% lower for main pulmonary artery vs. right ventricular stroke volume). Both datasets were internally consistent; 2D PC had a higher relative signal intensity, but no difference in signal-to-noise or contrast-to-noise ratios (SNR/CNR).
conclusionNon-contrast 4D flow correlates well with 2D PC in CHD with a slight underestimation in flows and overestimation in peak velocities, but good internal consistency and comparable SNR/CNR.
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