日本小児循環器学会雑誌 Pediatric Cardiology and Cardiac Surgery

Cardiac magnetic resonance imaging (MRI) is a three-dimensional modality for evaluating the beating heart, not only by anatomy but also by blood flow dynamics even in the complex cardiovascular system of congenital heart disease. Four-dimensional (4D) flow MRI is particularly useful for assessing cardiac anatomy and function by three directional ECG-gated cine phase contrast at the same time. The advantages of 4D flow MRI are free and systematic access to all intracardiac and extracardiac lesions, which are often difficult to visualize by echocardiography. The most important feature of 4D flow MRI is the quantitative assessment of blood flow, including shunt flow ratio and valve regurgitation volume. In cardiac surgery for congenital heart disease, a recent advance in 4D flow MRI is computational fluid dynamic (CFD) simulation combined with computational graphics. This CFD simulation can help prospective surgical design and treatment strategy as well as predict perioperative management and postoperative hemodynamics.