Mapping aortic hemodynamics using 3D cine phase contrast magnetic resonance parallel imaging: evaluation of an anisotropic diffusion filter.

PURPOSE: To propose and evaluate an anisotropic diffusion filter to improve visualization and analysis of the thoracic aorta local hemodynamics from phase-contrast MRI sensitivity encoding imaging. METHODS: The filter parameters were tailored to the phase-contrast MRI sensitivity encoding data, using a simple calibration procedure. The filter was applied to 20 phase-contrast MR image studies (five subjects acquired with four different sensitivity encoding reduction factors). The filter effect was estimated with respect to image quality (noise in velocity images, σ(n)), regularity of the velocity fields (divergence; relative error in velocity magnitude, and absolute error in flow direction), aorta flow pattern visualization (streamlines, secondary flows) and flow rate quantification. RESULTS: σ(n) decreased up to three times, divergence, error in velocity magnitude, and absolute error in flow direction decreased (by at least 313, 40, and 10%, respectively), indicating less noisy and more regular velocity fields after filtering. Streamline analysis confirmed the beneficial effect of anisotropic diffusion filter, both visually and quantitatively (streamline numbers increased by 207% in whole cardiac cycle and by 180% in systolic phase). A high correlation (r = 0.99) between the prefiltering and postfiltering aortic flow rate values was found. CONCLUSION: The anisotropic diffusion filter approach can be considered effective in improving the visualization and analysis of the thoracic aorta hemodynamics from phase-contrast MRI sensitivity encoding images.

On the use of in vivo measured flow rates as boundary conditions for image-based hemodynamic models of the human aorta: implications for indicators of abnormal flow.

The purpose of this study is to investigate how the imposition of personalized, non-invasively measured blood flow rates as boundary conditions (BCs) influences image-based computational hemodynamic studies in the human aorta. We extracted from 4D phase-contrast MRI acquisitions of a healthy human (1) the geometry of the thoracic aorta with supra-aortic arteries and (2) flow rate waveforms at all boundaries. Flow simulations were carried out, and the implications that the imposition of different BC schemes based on the measured flow rates have on wall shear stress (WSS)-based indicators of abnormal flow were analyzed. Our results show that both the flow rate repartition among the multiple outlets of the aorta and the distribution and magnitude of the WSS-based indicators are strongly influenced by the adopted BC strategy. Keeping as reference hemodynamic model the one where the applied BC scheme allowed to obtain a satisfactory agreement between the computed and the measured flow rate waveforms, differences in WSS-based indicators up to 49% were observed when the other BC strategies were applied. In conclusion, we demonstrate that in subject-specific computational hemodynamics models of the human aorta the imposition of BC settings based on non-invasively measured flow rate waveforms influences indicators of abnormal flow to a large extent. Hence, a BCs set-up assuring realistic, subject-specific instantaneous flow rate distribution must be applied when BCs such as flow rates are prescribed.

Does the Ventrica magnetic vascular positioner (MVP) for coronary artery bypass grafting significantly alter local fluid dynamics? A numeric study.

OBJECTIVE: Automatic devices have been recently introduced to make the anastomosis procedure quick and efficient when creating a coronary bypass on the beating heart. However, the implantation of these devices could modify the graft configuration, consistently affecting the hemodynamics usually found in the traditional anastomosis. As local fluid dynamics could play a significant role in the onset of vessel wall pathologies, in this article a computational approach was designed to investigate flow patterns in the presence of the Ventrica magnetic vascular positioner (Ventrica MVP) device. METHODS: A model of standard hand-sewn anastomosis and of automated magnetic anastomosis were constructed, and the finite volume method was used to simulate in silico realistic graft hemodynamics. Synthetic analytical descriptors -- i.e., time-averaged wall shear stress (TAWSS), oscillating shear index (OSI) and helical flow index (HFI) -- were calculated and compared for quantitative assessment of the anastomosis geometry hemodynamic performance. RESULTS: In this case study, the same most critical region was identified for the 2 models as the one with the lowest TAWSS and the highest OSI (TAWSS=0.229, OSI=0.255 for the hand-sewn anastomosis; TAWSS=0.297, OSI=0.171 for the Ventrica MVP(R)). However, the shape of the Ventrica MVP does not induce more critical wall shear stresses, oscillating flow and damped helicity in the graft fluid dynamics, as compared with conventional anastomosis. CONCLUSIONS: We found that the use of the Ventrica MVP for the case study under investigation was not associated with more critical fluid dynamics than with conventional hand-sewn anastomosis. Thereby, the device could facilitate beating heart and minimally invasive coronary artery bypass grafting without increasing local hemodynamic-related risks of failure.