Quantitative imaging for early detection and risk stratification of cardiovascular disease using 4D flow MRI and arterial spin labelling

Heart failure (HF) significantly burdens global healthcare, necessitating early detection and precise risk stratification. Advanced imaging techniques like 4D flow Magnetic resonance imaging (MRI) and arterial spin labelling (ASL) provide crucial insights into cardiac function by capturing complex flow patterns and measuring myocardial blood flow. Hence, this study explores how these modalities can enhance early detection and risk assessment of cardiovascular diseases, aiming to improve patient outcomes. Ten patients aged ≤ 65 with clinically compensated cardiomyopathy were recruited. MRI examinations included 4D flow MRI using a 1.5 T Philips Achieva Scanner and ASL imaging on a 3 Tesla scanner. Data analysis for 4D flow MRI involved segmenting the left ventricle and categorizing pathlines into flow components, while ASL data were analyzed using Buxton's model to quantify myocardial blood flow (MBF). The study population had a mean age of 49 ± 14 years, predominantly female (6:4). Average heart rate was 61 ± 11 bpm and blood pressures averaged 122/77 mmHg. Left ventricular end-diastolic volume was 179 ± 33 mL with an ejection fraction of 42 ± 5%. Patients showed lower direct flow volume and kinetic energy in early diastolic phases compared to healthy individuals. In conclusion, 4D flow MRI and accelerated ASL is effective for early detection and risk stratification in cardiovascular disease, offering enhanced cardiovascular assessment and potential improvements in patient care.