4D Flow is a visualization mode for magnetic resonance images that allows you to study vascular flows, that is, it provides more precise information, and thanks to Artificial Intelligence (AI), about the direction that the blood takes in the different vessels. . of the heart, but also the existence of difficulty of passage, if any, through its different cavities, the exact speed at which that flow reaches it.
«It is especially used to evaluate valvular heart disease and also to study arteriovenous shunts or short circuits between the cardiac chambers, as well as other areas of the heart; in the brain, its use can also be useful to analyze how blood flow is in aneurysms, for example,” explains the doctor. Vicente Martínez de Vega.head of the Diagnostic Imaging Service at the Quirónsalud Madrid University Hospital.
Precisely, this health center is one of the few that have the 4D Flow sequence in Spain, a technique where artificial intelligence is applied to magnetic resonance imaging of the heart and facilitating more accurate diagnoses between different heart conditions.
«The 4D Flow technique has come to provide numerous advantages over the basic sequences that we already have in conventional MRI. 4D Flow helps us avoid additional and unnecessary studies, allowing us to provide definitive diagnoses in a consistent manner,” Dr. Martínez de Vega also emphasizes.
We go from 2D to 4D
4D Flow analyzes are very useful in the assessment of cardiac flows, which is very useful in congenital heart diseases, as this specialist continues, as well as in the study of diseases of the heart valvesmainly those caused by the difficulty in closing them, and in the assessment of blood flows at the level of the aorta.
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And for cardiologists, knowing the flow of blood within the cardiac chambers is essential for the diagnosis of countless diseases. Until now, this expert points out that these flows are measured through graphs from ultrasound (2 dimensions), but the study through magnetic resonance thanks to the 4D Flow sequence “has revolutionized the way of seeing blood flows within of the heart, helping cardiologists to improve their diagnoses,” he insists.
As described by the cardiologist at the Quirónsalud Madrid University Hospital and expert in cardiac imaging, Dr. Javier Urmeneta, cardiac ultrasound has to go through the costal arches, the subcutaneous tissue and the air-filled lung to observe the cardiac structures. «However, through cardiac resonance you can see the heart without these inconveniences. As a great friend says: ultrasound is as if we focused a flashlight on an object in a dark room; while the MRI with the 4D Flow sequence is to turn on the light in the room », he points out.
With this, he highlights that the advantages of magnetic resonance in the study of cardiac imaging are accentuated if 4D Flow sequences are used, since they allow the activity of the heart to be assessed in four dimensions (the three spatial dimensions and time): «We observe In three dimensions, with color and in movement, the cardiac flows of the contraction and relaxation of the heart. It is a huge difference with the assessment of cardiac flows in two dimensions. All this in a very fast, reproducible way, and that cannot be done through two-dimensional techniques.
Accurate diagnosis without doubts
For his part, Dr. José Ángel Cabrera, head of the Cardiology Service at the Quirónsalud Madrid University Hospital, points out that in this way the 4D Flow sequence allows the assessment of any cardiac structure that has sufficient size and mobility: «In general terms, the flow within the cardiac chambers, the functioning of the valves, and the large vessels that leave the heart.
In his opinion, all these qualities help cardiologists “a lot” to make a correct diagnosis: “Having a complete three-dimensional volume of the heart and the great vessels allows us to assess any flow within it and respond to an endless number of clinical questions; All this in a quick, simple and forceful way.
At the same time, it highlights that 4D Flow helps solve diagnostic problems in the usual daily clinic such as insufficiencies, aortic valve pathology, or certain pathologies that affect congenital heart anomalies.