Vascular Blood Flow Imaging: Pushing Boundaries, Shaping the Future

Among all vascular imaging modalities currently used in clinical practice, Doppler ultrasound is the only modality that provides real-time physiological information of blood flow. However, Doppler ultrasound lacks accurate visualization and quantification of blood flow patterns in multiple dimensions, potentially leading to erroneous velocity estimates and restricting diagnostic capabilities. Since hemodynamic forces play an essential role in the initiation and progression of vascular pathologies, 2D and 3D flow imaging and quantification techniques are needed for improving cardiovascular health care. This perspective review addresses novel techniques that can be used to analyze blood flow in a clinical setting, covering 4D flow magnetic resonance imaging (4D flow MRI), patient-specific image-based computational fluid dynamics (CFD), and ultrasound-based velocity vector imaging (US-VVI). Moreover, different US-VVI methods and clinical applications, along with potential future directions, will be extensively discussed.