Time‐resolved three‐dimensional phase contrast MRI (4D flow) of aortic blood flow requires acceleration to reduce scan time. Two established techniques for highly accelerated 4D flow MRI are k‐t principal component analysis (k‐t PCA) and compressed sensing (CS), which employ either regular or random k‐space undersampling. The goal of this study was to gain insights into the quantitative differences between k‐t PCA‐ and CS‐derived aortic blood flow, especially for high temporal resolution CS 4D flow MRI.

The scan protocol consisted of both k‐t PCA and CS accelerated 4D flow MRI, as well as a 2D flow reference scan through the ascending aorta acquired in 15 subjects. 4D flow scans were accelerated with factor R = 8. For CS accelerated scans, we used a pseudo‐spiral Cartesian sampling scheme, which could additionally be reconstructed at higher temporal resolution, resulting in R = 13. 4D flow data were compared with the 2D flow scan in terms of flow, peak flow and stroke volume. A 3D peak systolic voxel‐wise velocity and wall shear stress (WSS) comparison between k‐t PCA and CS 4D flow was also performed.

The mean difference in flow/peak flow/stroke volume between the 2D flow scan and the 4D flow CS with R = 8 and R = 13 was 4.2%/9.1%/3.0% and 5.3%/7.1%/1.9%, respectively, whereas for k‐t PCA with R = 8 the difference was 9.7%/25.8%/10.4%. In the voxel‐by‐voxel 4D flow comparison we found 13.6% and 3.5% lower velocity and WSS values of k‐t PCA compared with CS with R = 8, and 15.9% and 5.5% lower velocity and WSS values of k‐t PCA compared with CS with R = 13.

Pseudo‐spiral accelerated 4D flow acquisitions in combination with CS reconstruction provides a flexible choice of temporal resolution. We showed that our proposed strategy achieves better agreement in flow values with 2D reference scans compared with using k‐t PCA accelerated acquisitions.