Evidence map›Paper›PMID 41856321›Full record

ArticleJournal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance2026

Comparison of free-running whole-heart five-dimensional and four-dimensional flow imaging to standard two-dimensional flow in patients with congenital heart disease.

Fabienne Dirbach, Estelle Tenisch, Milan Prša, Christopher W Roy, Sara Fässler, Paolo Garelli, David Rodrigues, Mariana B L Falcão, Michael Markl, Matthias Stuber and 2 more

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In one paragraph

Article in Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Fabienne DirbachService of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; Centre de Résonance Magnétique Cardiaque (CRMC) du CHUV, Lausanne University Hospital, Lausanne, Switzerland.
Estelle TenischDepartment of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Milan PršaPediatric Cardiology Unit, Woman-Mother-Child Department, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Christopher W RoyDepartment of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Sara FässlerService of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Paolo GarelliService of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
David RodriguesDepartment of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Mariana B L FalcãoDepartment of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Michael MarklDepartment of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States; Department of Biomedical Engineering, Northwestern University, Chicago, Illinois, United States.
Matthias StuberDepartment of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; Center for Biomedical Imaging (CIBM), Lausanne, Switzerland.
Jürg SchwitterService of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; Centre de Résonance Magnétique Cardiaque (CRMC) du CHUV, Lausanne University Hospital, Lausanne, Switzerland.
Tobias RutzService of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; Centre de Résonance Magnétique Cardiaque (CRMC) du CHUV, Lausanne University Hospital, Lausanne, Switzerland. Electronic address: tobias.rutz@chuv.ch.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFlow quantification by cardiovascular magnetic resonance (CMR) is essential for diagnosis-making and follow-up in patients with congenital heart disease (CHD). Standard two-dimensional phase-contrast (2D flow) sequences require, however, precise image plane prescription, resulting in long exam times. Free-breathing three-dimensional (3D) whole-heart flow sequences (four-dimensional [4D] flow) offer faster acquisition but require respiratory navigation, rendering exam duration unpredictable. Free-running radial, fully self-gated, respiratory and cardiac motion-resolved five-dimensional (5D) flow promises ease of use and stable scan duration. This study compared net flow volumes (NFV) between 2D, 4D, and 5D flow and maximum peak velocity (Vmax) to transthoracic echocardiography (TTE).

methodsCHD patients were scanned on a 1.5T scanner. 2D flow was performed in the ascending (AAo), descending aorta, main (MPA), right, and left pulmonary arteries, superior vena cava, and pulmonary veins. By an in-house prototype whole-heart free-running 3D radial phase-contrast CMR sequence, end-expiratory 5D flow images were obtained. Finally, 4D flow data were collected. 3D vessel segmentation was performed for 4D and 5D flow datasets. NFV were compared between 2D, 4D, and 5D flow and Vmax to TTE.

resultsFifty-nine CHD patients (median age 28, interquartile range 17.5, 42% (25/59) women) with right- and/or left-sided CHD were included. Scan duration did not differ significantly between methods. 4D and 5D flow underestimated NFV relative to 2D flow by 4-17 mL per beat which was less prominent for 5D flow and larger vessels. Internal agreement was best for 4D flow, followed by 5D flow, while 2D flow showed the largest variability: MPA vs AAo (bias mL, 95% limits of agreement): 2D flow: -4.84 (-34.18, 24.5), 4D flow -0.84 (-17.85, 16.18), and 5D flow -6.4 (-28.53, 15.73). 2D and 4D but not 5D flow underestimated Vmax compared to TTE: AAo: TTE 120 ± 46; 2D 108 ± 36; 4D 107 ± 36; 5D 115 ± 40 cm/s; p < 0.03 TTE vs 2D and 4D flow; p = 0.253 TTE vs 5D flow.

conclusion4D and 5D flow provided measurements comparable to 2D flow. Despite systematic underestimation of NFV, internal agreement of whole-heart methods was superior, while scan time did not increase significantly. 5D flow yielded the most accurate Vmax compared to TTE, supporting its potential for comprehensive non-invasive hemodynamic evaluation.

Indexed as

4D flow MRI5D flowCongenital heart diseaseFlow quantificationFree runningPhase-contrast magnetic resonance imaging

Identifiers

PMID41856321
PMCPMC13321021

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.