Abstract Four-dimensional flow magnetic resonance imaging (4D Flow MRI) enables time-resolved three-dimensional visualization and retrospective quantification of vascular hemodynamics within a single volumetric acquisition. Beyond morphology-based imaging, it provides comprehensive assessment of multidirectional flow patterns, collateral redistribution, and treatment-related hemodynamic changes across vascular territories. In abdominal interventional radiology (IR), 4D Flow MRI may offer incremental value in clinical scenarios where morphology alone is insufficient to characterize physiologically relevant hemodynamics. This review summarizes its applications in aortic interventions, portal venous interventions, and hepatic venous outflow disorders. In these settings, 4D Flow MRI may support functional assessment of endoleaks, evaluation of portal flow redistribution, and characterization of venous outflow obstruction and treatment response. Among current applications, endoleak characterization and early assessment of portal hemodynamic change after portal vein embolization, which may reflect subsequent liver hypertrophy, represent particularly promising use cases.
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