CTICasesBicuspid Aortic Valve 4D Flow MRI
Imaging findings
Cardiac 4D flow MRI in two young patients with bicuspid aortic valves demonstrates different flow profiles in the ascending aorta. The first patient shows an off-center, eccentric, helical jet of flow during systole that directly impacts the lateral aortic wall, creating high wall shear stress and local eddy currents. The second patient demonstrates a more centered, laminar flow pattern with evenly distributed forces.
Key takeaways
4D flow cardiac MRI can visualize and quantify altered flow hemodynamics and wall shear stress in patients with bicuspid aortic valves. Eccentric, off-center systolic jets are associated with increased localized wall shear stress, which predisposes patients to asymmetric aortic dilation and aneurysm formation, whereas laminar flow patterns distribute forces more evenly and are less prone to rapid dilation.
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