'4D flow MRI' assesses blood flow in heart failure patients

A research team led by the University of East Anglia (UEA) has developed cutting-edge imaging technology to help doctors better diagnose and monitor patients with heart failure, using magnetic resonance imaging (MRI) to create detailed 4D flow images of the heart. A new study in the International Journal of Cardiology has now shown how this non-invasive imaging technique can precisely measure the peak velocity of blood flow in the heart, with the research team hopeful that their work could revolutionise how heart failure is diagnosed.

“Heart failure is a dreadful condition resulting from rising pressures inside the heart,” said lead researcher Dr Pankaj Garg, from UEA’s Norwich Medical School. “The best method to diagnose heart failure is by invasive assessment, which is not preferred as it has risks.

“An ultrasound scan of the heart called echocardiography is routinely used to measure the peak velocity of blood flow through the mitral valve of the heart. However, ultrasound assessment is dependent on the operator and can be unreliable.

“In our study, we used one of the most cutting-edge methods of flow assessment inside the heart called 4D flow MRI. In 4D flow MRI, we can look at the flow in three directions over time — the fourth dimension.”

The 4D flow MRI — or 4D flow cardiac magnetic resonance (CMR) — scan takes just 6–8 minutes and can provide precise imaging of the heart valves and the flow inside the heart, helping doctors determine the best course of treatment for patients. The team collaborated with industry partner Pie Medical Imaging from the Netherlands to develop prototype software to automate the process of measuring the peak velocity of blood flow inside the heart.

“This work is very important because the heart’s inability to relax leads to a rise in pressures inside the heart, and this causes heart failure with preserved ejection fraction,” Garg said.

“Peak velocity of the blood flow inside the heart is a very important assessment for patients, and our findings show that by using a state-of-the-art 4D flow MRI imaging, we can do this accurately and with a high degree of repeatability.”

The team tested the new technology with 50 patients at the Norfolk and Norwich University Hospital and at the Sheffield Teaching Hospitals NHS Foundation Trust. Patients with suspected heart failure were assessed using both echocardiography and the new 4D flow MRI.

“We applied automated methods to hunt for the peak velocity in the chamber of the heart and showed that it is similar to echocardiography assessment, but with much greater precision,” Garg said.

“This advanced imaging offers an alternative to ultrasound methods and may even be better than ultrasound in the future.”

Image credit: ©stock.adobe.com/au/7activestudio

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