{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T16:10:20Z","timestamp":1776183020141,"version":"3.50.1"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,3,29]],"date-time":"2026-03-29T00:00:00Z","timestamp":1774742400000},"content-version":"vor","delay-in-days":87,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006775","name":"GE Healthcare","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006775","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003061","name":"Erasmus MC","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003061","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004830","name":"Siemens","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004830","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100020588","name":"Heartflow","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100020588","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100030777","name":"Bracco","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100030777","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To compare transthoracic echocardiography (TTE), 2D and 4D flow cardiovascular magnetic resonance (CMR) for the evaluation of valve function and flow measurements after percutaneous pulmonary valve implantation (PPVI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>In this multicentre exploratory observational study, 29 patients who underwent PPVI were planned for TTE and CMR with 2D and 4D flow measurements after PPVI. Peak velocity was measured with all techniques. Net and regurgitating flow measurements were measured with CMR distal to the transcatheter pulmonary valve (TPV). Median peak velocity of the TPV with TTE was 2.5 (2.0\u20133.1) m\/s, with 2D flow CMR 2.3 (2.0\u20133.2) m\/s, and with 4D flow 2.3 (2.0\u20133.0) m\/s. There was a good correlation for the peak velocity of the TPV between TTE and 2D flow CMR (r = 0.68, P &amp;lt; 0.001) and a moderate correlation for peak velocity between TTE and 4D flow CMR (r = 0.56, P = 0.003), and between 2D flow and 4D flow CMR (r = 0.56, P = 0.006). For peak velocity measurements, no proportional bias was observed between the three imaging techniques. For the CMR flow measurements, a strong correlation was observed between 2D and 4D flow CMR, for both net flow (r = 0.87, P &amp;lt; 0.001) and regurgitation fraction (r = 0.96, P &amp;lt; 0.001) of the TPV. Net flow through the left pulmonary artery correlated strongly between 2D and 4D flow CMR (r = 0.85, P &amp;lt; 0.001), and there was a good correlation for the right pulmonary artery (r = 0.65, P &amp;lt; 0.01). For net flow measurements of the TPV, we found an underestimation of flow measurements at higher flow rates with 4D flow CMR, compared to 2D flow CMR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>TTE, 2D flow CMR, and 4D flow CMR are all feasible and reliable imaging techniques after PPVI, concordant in predominantly mild-to-moderate stenosis. These findings strengthen the use of 2D and 4D flow CMR as a tool for post-PPVI assessment, despite stent-induced artefacts, although reliability in more advanced valve dysfunction remains uncertain.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjimp\/qyag054","type":"journal-article","created":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T12:48:37Z","timestamp":1774615717000},"source":"Crossref","is-referenced-by-count":0,"title":["Comparing transthoracic echocardiography, 2D and 4D flow cardiovascular magnetic resonance for quantitative valve assessment after percutaneous pulmonary valve implantation"],"prefix":"10.1093","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5937-6892","authenticated-orcid":false,"given":"Marguerite E","family":"Faure","sequence":"first","affiliation":[{"name":"Department of Radiology and Nuclear Medicine, Erasmus MC , Room Rg-419, PO Box 2040, 3000 CA, Rotterdam ,","place":["The Netherlands"]},{"name":"Department of Radiology, AZ Monica , Antwerp ,","place":["Belgium"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joao G","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine, Erasmus MC , Room Rg-419, PO Box 2040, 3000 CA, Rotterdam ,","place":["The Netherlands"]},{"name":"Department of Radiology, Centro Hospitalar Universit\u00e1rio de Santo Ant\u00f3nio , Porto ,","place":["Portugal"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0422-9860","authenticated-orcid":false,"given":"Annemien E","family":"van den Bosch","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiovascular Institute, Thorax Center, Erasmus MC , Room Rg-419, PO Box 2040, 3000 CA, Rotterdam ,","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeroen M","family":"Wilschut","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiovascular Institute, Thorax Center, Erasmus MC , Room Rg-419, PO Box 2040, 3000 CA, Rotterdam ,","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tim","family":"ten Cate","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Radboud University Medical Center , Nijmegen ,","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5064-0143","authenticated-orcid":false,"given":"Anthonie L","family":"Duijnhouwer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Radboud University Medical Center , Nijmegen ,","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6770-3830","authenticated-orcid":false,"given":"Jolien W","family":"Roos-Hesselink","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiovascular Institute, Thorax Center, Erasmus MC , Room Rg-419, PO Box 2040, 3000 CA, Rotterdam ,","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ricardo P J","family":"Budde","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine, Erasmus MC , Room Rg-419, PO Box 2040, 3000 CA, Rotterdam ,","place":["The Netherlands"]},{"name":"Department of Cardiology, Cardiovascular Institute, Thorax Center, Erasmus MC , Room Rg-419, PO Box 2040, 3000 CA, Rotterdam ,","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3315-2006","authenticated-orcid":false,"given":"Alexander","family":"Hirsch","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine, Erasmus MC , Room Rg-419, PO Box 2040, 3000 CA, Rotterdam ,","place":["The Netherlands"]},{"name":"Department of Cardiology, Cardiovascular Institute, Thorax Center, Erasmus MC , Room Rg-419, PO Box 2040, 3000 CA, Rotterdam ,","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,3,29]]},"reference":[{"key":"2026041411161235900_qyag054-B1","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1148\/rg.210160","article-title":"Pre- and postprocedure imaging of transcatheter pulmonary valve implantation","volume":"42","author":"Canan","year":"2022","journal-title":"Radiographics"},{"key":"2026041411161235900_qyag054-B2","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1055\/s-2007-1023399","article-title":"The natural history of isolated congenital pulmonary valve incompetence: surgical implications","volume":"32","author":"Shimazaki","year":"1984","journal-title":"Thorac Cardiovasc Surg"},{"key":"2026041411161235900_qyag054-B3","doi-asserted-by":"crossref","first-page":"1403","DOI":"10.1016\/S0140-6736(00)02844-0","article-title":"Percutaneous replacement of pulmonary valve in a right-ventricle to pulmonary-artery prosthetic conduit with valve dysfunction","volume":"356","author":"Bonhoeffer","year":"2000","journal-title":"Lancet"},{"key":"2026041411161235900_qyag054-B4","doi-asserted-by":"crossref","first-page":"1801","DOI":"10.1016\/S0003-4975(02)03568-3","article-title":"One hundred pulmonary valve replacements in children after relief of right ventricular outflow tract obstruction","volume":"73","author":"Kanter","year":"2002","journal-title":"Ann Thorac Surg"},{"key":"2026041411161235900_qyag054-B5","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1053\/j.semtcvs.2006.07.006","article-title":"Current experience with percutaneous pulmonary valve implantation","volume":"18","author":"Nordmeyer","year":"2006","journal-title":"Semin Thorac Cardiovasc Surg"},{"key":"2026041411161235900_qyag054-B6","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1016\/j.ejrad.2018.11.018","article-title":"Cardiac CT to assess the risk of coronary compression in patients evaluated for percutaneous pulmonary valve implantation","volume":"110","author":"Tezza","year":"2019","journal-title":"Eur J Radiol"},{"key":"2026041411161235900_qyag054-B7","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1093\/ehjci\/jet105","article-title":"Recommendations for the echocardiographic assessment of native valvular regurgitation: an executive summary from the European association of cardiovascular imaging","volume":"14","author":"Lancellotti","year":"2013","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2026041411161235900_qyag054-B8","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1111\/chd.12762","article-title":"Echocardiographic parameters of severe pulmonary regurgitation after surgical repair of tetralogy of fallot","volume":"14","author":"Van Berendoncks","year":"2019","journal-title":"Congenit Heart Dis"},{"key":"2026041411161235900_qyag054-B9","first-page":"69","article-title":"Statistics corner: a guide to appropriate use of correlation coefficient in medical research","volume":"24","author":"Mukaka","year":"2012","journal-title":"Malawi Med J"},{"key":"2026041411161235900_qyag054-B10","doi-asserted-by":"crossref","first-page":"012062","DOI":"10.1088\/1742-6596\/694\/1\/012062","article-title":"The correlation between effective renal plasma flow (ERPF) and glomerular filtration rate (GFR) with renal scintigraphy 99mTc-DTPA study","volume":"694","author":"Ratnasari","year":"2016","journal-title":"J Phys Conf Ser"},{"key":"2026041411161235900_qyag054-B11","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/S0140-6736(86)90837-8","article-title":"Statistical methods for assessing agreement between two methods of clinical measurement","volume":"1","author":"Bland","year":"1986","journal-title":"Lancet"},{"key":"2026041411161235900_qyag054-B12","doi-asserted-by":"crossref","first-page":"1627","DOI":"10.1007\/s00246-023-03238-2","article-title":"Comparison of four-dimensional flow MRI, two-dimensional phase-contrast MRI and echocardiography in transposition of the great arteries","volume":"45","author":"Warmerdam","year":"2024","journal-title":"Pediatr Cardiol"},{"key":"2026041411161235900_qyag054-B13","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1002\/jmri.24959","article-title":"Reproducibility and interobserver variability of systolic blood flow velocity and 3D wall shear stress derived from 4D flow MRI in the healthy aorta","volume":"43","author":"van Ooij","year":"2016","journal-title":"J Magn Reson Imaging"},{"key":"2026041411161235900_qyag054-B14","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1002\/jmri.22280","article-title":"Flow-sensitive four-dimensional cine magnetic resonance imaging for offline blood flow quantification in multiple vessels: a validation study","volume":"32","author":"Nordmeyer","year":"2010","journal-title":"J Magn Reson Imaging"},{"key":"2026041411161235900_qyag054-B15","doi-asserted-by":"crossref","first-page":"1849","DOI":"10.1016\/j.ejrad.2016.07.018","article-title":"Cloud-processed 4D CMR flow imaging for pulmonary flow quantification","volume":"85","author":"Chelu","year":"2016","journal-title":"Eur J Radiol"},{"key":"2026041411161235900_qyag054-B16","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/j.ijcard.2019.10.030","article-title":"4D flow MRI versus conventional 2D for measuring pulmonary flow after tetralogy of fallot repair","volume":"300","author":"Isorni","year":"2020","journal-title":"Int J Cardiol"},{"key":"2026041411161235900_qyag054-B17","doi-asserted-by":"crossref","first-page":"714","DOI":"10.1002\/jmri.10008","article-title":"Assessing the accuracy of two-dimensional phase-contrast MRI measurements of complex unsteady flows","volume":"14","author":"Papaharilaou","year":"2001","journal-title":"J Magn Reson Imaging"},{"key":"2026041411161235900_qyag054-B18","doi-asserted-by":"crossref","first-page":"1111","DOI":"10.1007\/s10554-019-01593-x","article-title":"Validation of 4D flow CMR against simultaneous invasive hemodynamic measurements: a swine study","volume":"35","author":"Stam","year":"2019","journal-title":"Int J Cardiovasc Imaging"},{"key":"2026041411161235900_qyag054-B19","doi-asserted-by":"crossref","first-page":"6313","DOI":"10.1007\/s00330-025-11542-z","article-title":"Non-enhanced MRI flow evaluation using 4D versus 2D phase-contrast in repaired tetralogy of fallot adults","volume":"35","author":"Champollion","year":"2025","journal-title":"Eur Radiol"},{"key":"2026041411161235900_qyag054-B20","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1002\/jmri.70131","article-title":"Reliability of 4D flow MRI-derived pulmonary regurgitant fraction in repaired tetralogy of fallot: impact of measurement location and pulmonary artery geometry","volume":"63","author":"Mori","year":"2026","journal-title":"J Magn Reson Imaging"},{"key":"2026041411161235900_qyag054-B21","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1186\/s41747-022-00299-5","article-title":"Kat-ARC accelerated 4D flow CMR: clinical validation for transvalvular flow and peak velocity assessment","volume":"6","author":"Assadi","year":"2022","journal-title":"Eur Radiol Exp"},{"key":"2026041411161235900_qyag054-B22","doi-asserted-by":"crossref","first-page":"10569","DOI":"10.1038\/s41598-020-66659-6","article-title":"Validation of four-dimensional flow cardiovascular magnetic resonance for aortic stenosis assessment","volume":"10","author":"Archer","year":"2020","journal-title":"Sci Rep"},{"key":"2026041411161235900_qyag054-B23","doi-asserted-by":"crossref","first-page":"1000","DOI":"10.1111\/j.1540-8175.2009.00909.x","article-title":"Discrepancy between gradients derived by cardiac catheterization and by Doppler echocardiography in aortic stenosis: how often does pressure recovery play a role?","volume":"26","author":"Parameswaran","year":"2009","journal-title":"Echocardiography"},{"key":"2026041411161235900_qyag054-B24","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.echo.2008.11.029","article-title":"Echocardiographic assessment of valve stenosis: EAE\/ASE recommendations for clinical practice","volume":"22","author":"Baumgartner","year":"2009","journal-title":"J Am Soc Echocardiogr"},{"key":"2026041411161235900_qyag054-B25","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1161\/CIRCIMAGING.112.972588","article-title":"Quantifying pulmonary regurgitation and right ventricular function in surgically repaired tetralogy of fallot: a comparative analysis of echocardiography and magnetic resonance imaging","volume":"5","author":"Mercer-Rosa","year":"2012","journal-title":"Circ Cardiovasc Imaging"},{"key":"2026041411161235900_qyag054-B26","doi-asserted-by":"crossref","first-page":"3606","DOI":"10.1007\/s00330-015-3781-5","article-title":"Four-year cardiac magnetic resonance (CMR) follow-up of patients treated with percutaneous pulmonary valve stent implantation","volume":"25","author":"Secchi","year":"2015","journal-title":"Eur Radiol"},{"key":"2026041411161235900_qyag054-B27","doi-asserted-by":"crossref","first-page":"1246","DOI":"10.1016\/j.amjcard.2019.07.036","article-title":"Meta-analysis of transthoracic echocardiography versus cardiac magnetic resonance for the assessment of aortic regurgitation after transcatheter aortic valve implantation","volume":"124","author":"Papanastasiou","year":"2019","journal-title":"Am J Cardiol"},{"key":"2026041411161235900_qyag054-B28","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1148\/radiol.2018180807","article-title":"Automated cardiac valve tracking for flow quantification with four-dimensional flow MRI","volume":"290","author":"Kamphuis","year":"2019","journal-title":"Radiology"},{"key":"2026041411161235900_qyag054-B29","doi-asserted-by":"crossref","first-page":"1354","DOI":"10.1016\/j.jcmg.2020.12.014","article-title":"Multicenter consistency assessment of valvular flow quantification with automated valve tracking in 4D flow CMR","volume":"14","author":"Juffermans","year":"2021","journal-title":"JACC Cardiovasc Imaging"},{"key":"2026041411161235900_qyag054-B30","doi-asserted-by":"crossref","first-page":"236 e1","DOI":"10.1016\/j.crad.2020.09.014","article-title":"A test-retest multisite reproducibility study of cardiovascular four-dimensional flow MRI without respiratory gating","volume":"76","author":"Zhang","year":"2021","journal-title":"Clin Radiol"}],"container-title":["European Heart Journal - Imaging Methods and Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjimp\/advance-article-pdf\/doi\/10.1093\/ehjimp\/qyag054\/67632729\/qyag054.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjimp\/article-pdf\/4\/1\/qyag054\/67632729\/qyag054.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjimp\/article-pdf\/4\/1\/qyag054\/67632729\/qyag054.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T15:16:22Z","timestamp":1776179782000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjimp\/article\/doi\/10.1093\/ehjimp\/qyag054\/8554335"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,1]]},"references-count":30,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjimp\/qyag054","relation":{},"ISSN":["2755-9637"],"issn-type":[{"value":"2755-9637","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,1]]},"published":{"date-parts":[[2026,1,1]]},"article-number":"qyag054"}}