Echo planar imaging–induced errors in intracardiac 4D flow MRI quantification

Jos J.M. Westenberg*, Hans C. van Assen, Pieter J. van den Boogaard, Jelle J. Goeman, Hicham Saaid, Jason Voorneveld, Johan Bosch, Sasa Kenjeres, Tom Claessens, More Authors

*Corresponding author for this work

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Purpose: To assess errors associated with EPI-accelerated intracardiac 4D flow MRI (4DEPI) with EPI factor 5, compared with non-EPI gradient echo (4DGRE). Methods: Three 3T MRI experiments were performed comparing 4DEPI to 4DGRE: steady flow through straight tubes, pulsatile flow in a left-ventricle phantom, and intracardiac flow in 10 healthy volunteers. For each experiment, 4DEPI was repeated with readout and blip phase-encoding gradient in different orientations, parallel or perpendicular to the flow direction. In vitro flow rates were compared with timed volumetric collection. In the left-ventricle phantom and in vivo, voxel-based speed and spatio-temporal median speed were compared between sequences, as well as mitral and aortic transvalvular net forward volume. Results: In steady-flow phantoms, the flow rate error was largest (12%) for high velocity (>2 m/s) with 4DEPI readout gradient parallel to the flow. Voxel-based speed and median speed in the left-ventricle phantom were ≤5.5% different between sequences. In vivo, mean net forward volume inconsistency was largest (6.4 ± 8.5%) for 4DEPI with nonblip phase-encoding gradient parallel to the main flow. The difference in median speed for 4DEPI versus 4DGRE was largest (9%) when the 4DEPI readout gradient was parallel to the flow. Conclusions: Velocity and flow rate are inaccurate for 4DEPI with EPI factor 5 when flow is parallel to the readout or blip phase-encoding gradient. However, mean differences in flow rate, voxel-based speed, and spatio-temporal median speed were acceptable (≤10%) when comparing 4DEPI to 4DGRE for intracardiac flow in healthy volunteers.

Original languageEnglish
Pages (from-to)2398-2411
Number of pages14
JournalMagnetic Resonance in Medicine
Issue number5
Publication statusPublished - 2021


  • 4D flow MRI
  • echo planar imaging
  • intracardiac blood flow
  • phase-contrast MRI


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