1. Northwestern CardiovascularMR Imaging Research Departments of Radiology & Biomedical Engineering Northwestern University, Chicago, IL, USA

2. CV-MRI 4D Flow Flow sensitive 4D Data 3D Visualization Adaptive navigator respiration control 4D (3D volume + time) Res. ~ 2mm3, TRes ~ 40ms, TAcq ~ 10-15minflow (3-dir. velocity encoding) MRIMarkl M, et al. JMRI 2007; 25:824-831 Markl M, et al. JCMR 2011; 13:7Frydrychowicz A, et al. J Cardiovasc Magn Reson 2008;10:30 3. 4D Flow MRIApplications Fluckiger JU, et al. JMRI 2013 Barker AJ, et al. Circ Cardiovasc Imaging 2012:457-466 Markl M, et al. JMRI 2012:1015-1036 Stankovicz Z, et al. Radiology 2012; 262:862-873 Markl M, et al. JCMR 2011; 13:7 Geiger J, et al. Eur Radiol 2011; 21:1651-1657 Markl M, et. al. EJCTS 2011; 39 206-212 Frydrychowicz A, et al. Invest Radiol 2011; 46:317-325 Markl M, et al. Circ Cardiovasc Imaging 2010; 3:647-655 Harloff A, et al. Stroke 2010; 41:1145-1150 Harloff A, et al. MRM 2009; 61:65-74Carotid arteries Portal vein Stalder AF, et al. MRM 2008; 60:1218-1231 Markl M, et al. JMRI 2007; 25:824-831 Wetzel S, et. al. AJNR 2007; 28:433-438 4. CV-MRI Thoracic 4D Flow MRI 3D blood flow characteristics in the aortic valve diseasem Comprehensive evaluation of hemodynamics3D flow jet patterns, wall shear stress, pressurem Significantly altered 3D flow and wall parametersInfluence of valve morphology on disease progressionsStructure-function relationshipm Impact of surgical therapy on aortic hemodynamics Barker AJ, et al. Circ Cardiovasc Imaging 2012:457-466 5. CV-MRINeurovascular Disease - AVM Arteriovenous malformation (AVM)m 3D visualization of AVM network Complex arterial feeding & venous draining patterns Pre-operative assessment & treatment planningm Intra-cranial blood flow quantification monitoring of treatment induced changes Ansari S, et al. AJNR 2013, in press 6. CV-MRINeurovascular Disease - Aneurysm 3D Flow in Intracranial Aneurysms Complex blood flow & wall shear stress patterns inside the aneurysm 2WSS [N/m] for 2 aneurysm groups 1.20 1.00velocity [m/s]Group 1Group 2 0.5saccular aneurysmfusiform aneurysm 0.80 0.60 0 0.40 0.20 0.00 Mean 0.400.04min 0.070.02max1.260.08 4D hemodynamics in cerebral aneurysmsm 3D flow visualization inside the aneurysmComplex blood flow patterns, Impact of flow changes on aneurysm wallm Quantification of altered hemodynamicsCorrelation of disease progression with regional flow characteristicsRisk stratification & treatment planningSchnell S, et al. J Magn Reson Imaging 2013, in press 7. CV-MRI 4D Flow MRI in CHDFontan circulation single ventricle extracardiac TCPC Congenital heart Disease: Comprehensive evaluation of flow & anatomy 3D visualization of complex hemodynamics & mixing in CHDFlow pathways in cardiac chambers & vessels Retrospective flow quantificationFull 3D coverage, no pre-defined 2D planesMarkl M, et al. J Magn Reson Imaging 2012:933937 8. CV-MRI 4D Flow MRI in CHD venous & pulmonary flowsystemic flow Fontan circulationsingle ventricleextracardiac TCPC Congenital heart Disease: Comprehensive evaluation of flow & anatomy 3D visualization of complex hemodynamics & mixing in CHDFlow pathways in cardiac chambers & vessels Retrospective flow quantificationFull 3D coverage, no pre-defined 2D planes Markl M, et al. J Magn Reson Imaging 2012:933937 9. CV-MRIWhole Heart 4D Flow Atrial Fibrillation: Quantification of Left atrial 3D Hemodynamics Comprehensive evaluation of atrial 3D flow 3D visualization of atrial hemodynamics Flow pathways in cardiac chambers Retrospective quantification 3D velocity distribution, flow coherence Fluckiger JU, et al. J Magn Reson Imaging 2013 10. AcknowledgementsNorthwestern CardiovascularMR Imaging ResearchMichael Markl, PhDJames Carr, MDSusanne Schnell , PhD Alex Barker , PhDJacob Fluckiger , PhD Kelly Jarvis, BSCan Wu, MSBradley Allen , MDJulio Garcia Flores , PhD Pim van Ooij , PhDPegah Entezari , MD Jeremy Collins , MDZoran Stankovic , MDDepartments of Radiology & Biomedical EngineeringNorthwestern University, Chicago, IL, USA