FlowMoDL: Model-Based Deep Learning with Conjugate-Gradient Data Consistency for Highly Accelerated 4D Flow MRI Reconstruction

4D flow MRI measures time-resolved, three-directional blood velocity but requires long acquisition times, and its diagnostic signal is carried by the phase difference between velocity encodings, not by image magnitude. Recent work has developed a per-encoding variational network to address image reconstruction in this field. In this work, we incorporate a joint supervised and self-supervised training regime and utilize both magnitude and velocity data during supervision. At the same time, we add multiple acquisition-robust and conditioning strategies based on the acceleration factors. On the CMRx4DFlow~2026 aortic dataset (1.5 and 3T), our model lowers RelErr by $38$--$50\%$ and AngErr by $7.0$--$8.7^\circ$ against a training-matched baseline across $R{=}10$--$50$, improving on every held-out subject at every acceleration. Our model also shows strong generalization ability to transfer on out-of-distribution data by employing the joint training scheme, with an increase of $7.2\%$ in SSIM and decrease of $38\%$ and $31\%$ in AngErr and RelErr respectively.

While compressed-sensing regularizers enable interpretable reconstruction of 4D Flow CMR through transparent variational objectives, their hand-crafted nature is too restrictive under high acceleration. State-of-the-art learning-based approaches mitigate this, but typically encode regularization implicitly through unrolled network modules, which limits their interpretability. To address this limitation, we propose CLEAR, designed to combine the interpretability of compressed sensing with the flexibility of learned models. To the best of our knowledge, it is the first learned regularizer for a 4D reconstruction task. In the ultra-accelerated $10\times$--$50\times$ regime of the CMRx4DFlow2026 challenge, CLEAR outperforms compressed sensing locally low-rank (LLR) and the popular variational network FlowVN, while using less than 10k parameters and preserving an interpretable regularization structure.

This work introduces an unsupervised Divergence and Aliasing-Free neural network (DAF-FlowNet) for 4D Flow Magnetic Resonance Imaging (4D Flow MRI) that jointly enhances noisy velocity fields and corrects phase wrapping artifacts. DAF-FlowNet parameterizes velocities as the curl of a vector potential, enforcing mass conservation by construction and avoiding explicit divergence-penalty tuning. A cosine data-consistency loss enables simultaneous denoising and unwrapping from wrapped phase images. On synthetic aortic 4D Flow MRI generated from computational fluid dynamics, DAF-FlowNet achieved lower errors than existing techniques (up to 11% lower velocity normalized root mean square error, 11% lower directional error, and 44% lower divergence relative to the best-performing alternative across noise levels), with robustness to moderate segmentation perturbations. For unwrapping, at peak velocity/velocity-encoding ratios of 1.4 and 2.1, DAF-FlowNet achieved 0.18% and 5.2% residual wrapped voxels, representing reductions of 72% and 18% relative to the best alternative method, respectively. In scenarios with both noise and aliasing, the proposed single-stage formulation outperformed a state-of-the-art sequential pipeline (up to 15% lower velocity normalized root mean square error, 11% lower directional error, and 28% lower divergence). Across 10 hypertrophic cardiomyopathy patient datasets, DAF-FlowNet preserved fine-scale flow features, corrected aliased regions, and improved internal flow consistency, as indicated by reduced inter-plane flow bias in aortic and pulmonary mass-conservation analyses recommended by the 4D Flow MRI consensus guidelines. These results support DAF-FlowNet as a framework that unifies velocity enhancement and phase unwrapping to improve the reliability of cardiovascular 4D Flow MRI.