Four-dimensional flow MRI for evaluation of post-stenotic turbulent flow in a phantom: comparison with flowmeter and computational fluid dynamics.

Abstract

To validate 4D flow MRI in a flow phantom using a flowmeter and computational fluid dynamics (CFD) as reference. Validation of 4D flow MRI was performed using flow phantoms with 75% and 90% stenosis. The effect of spatial resolution on flow rate, peak velocity and flow patterns was investigated in coronal and axial scans. The accuracy of flow rate with 4D flow MRI was evaluated using a flowmeter as reference, and the peak velocity and flow patterns obtained were compared with CFD analysis results. 4D flow MRI accurately measured the flow rate in proximal and distal regions of the stenosis (percent error ≤3.6% in axial scanning with 1.6-mm resolution). The peak velocity of 4D flow MRI was underestimated by more than 22.8%, especially from the second half of the stenosis. With 1-mm isotropic resolution, the maximum thickness of the recirculating flow region was estimated within a 1-mm difference, but the turbulent velocity fluctuations mostly disappeared in the post-stenotic region. 4D flow MRI accurately measures the flow rates in the proximal and distal regions of a stenosis in axial scan but has limitations in its estimation of peak velocity and turbulent characteristics. • 4D flow MRI accurately measures the flow rate in axial scan. • The peak velocity was underestimated by 4D flow MRI. •4D flow MRI demonstrates the principal pattern of post-stenotic flow.