Work

Reproducibility of 4D Flow MRI-Derived Diastolic Function Testing by Mitral and Pulmonary Venous Flow Indices in Healthy Volunteers

Year: 2026

Type: article

Abstract: Accurate assessment of mitral valve (MV) and pulmonary vein (PV) flow velocities is important for left ventricular diastolic function testing. This study investigated the scan–rescan reproducibility of 4D Flow MRI-assessed MV and PV flow velocities in 21 healthy volunteers (25 ± 4 years). Participants underwent repeated whole-heart 3T 4D Flow MRI involving repositioning and different respiratory compensation strategies (motion-uncompensated free-breathing vs. respiratory motion-compensated navigator gating). MV parameters (net flow volume (NFV), E-wave velocity, A-wave velocity, E/A ratio, E deceleration time (DT), annular e’ velocity, E/e’ ratio) and PV parameters (NFV, S-wave velocity, D-wave velocity, S/D ratio, atrial reversal (AR) wave velocity) were derived from velocity–time curves and compared using intraclass correlation coefficients (ICCs), Bland–Altman analysis, and Pearson’s correlation (r). Results showed significant moderate-to-strong scan–rescan agreement and correlation for most MV and PV parameters (ICC = 0.51–0.92; r = 0.51–0.92; all p < 0.05), except E DT, e’ velocity, E/e’ ratio, PV NFV, and AR velocity (ICC = −0.13–0.47; r = −0.14–0.47). Subanalysis of respiratory motion strategies showed moderate-to-strong agreement and correlation for MV and PV parameters (ICC = 0.61–0.99; r = 0.52–0.99; all p < 0.05 excluding E DT), except E DT (ICC = 0.44) and PV NFV (ICC = 0.46; r = 0.46). While intraobserver agreement was mostly moderate-to-excellent (ICC = 0.58–0.97; ICC = 0.41 for E DT), interobserver agreement was poor for E DT and PV parameters (ICC = −0.12–0.34). Overall, 4D Flow MRI shows acceptable reproducibility for selected diastolic flow parameters, particularly mitral inflow indices, but substantial variability and limited robustness for key indices currently restrict its clinical applicability.

Source: Applied Sciences

DOI: 10.3390/app16083930

Authors: Thomas in de Braekt, Paul R. Roos, Patrick Houthuizen, Harrie C. M. van den Bosch, Hildo J. Lamb, Jos J. M. Westenberg

Institutions: Leiden University Medical Center, Catharina Ziekenhuis

Language: English

Topic: Cardiovascular Function and Risk Factors

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,896