Progress towards patient-specific computational flow modeling of the left heart via combination of magnetic resonance imaging with computational fluid dynamics.

A combined computational fluid dynamics (CFD) and magnetic resonance imaging (MRI) methodology has been developed to simulate blood flow in a subject-specific left heart. The research continues from earlier experience in modeling the human left ventricle using time-varying anatomical MR scans. Breathing artifacts are reduced by means of a MR navigator echo sequence with feedback to the subject, allowing a near constant breath-hold diaphragm position. An improved interactive segmentation technique for the long- and short-axis anatomical slices is used. The computational domain is extended to include the proximal left atrium and ascending aorta as well as the left ventricle, and the mitral and aortic valve orifices are approximately represented. The CFD results show remarkable correspondence with the MR velocity data acquired for comparison purposes, as well as with previously published in vivo experiments (velocity and pressure). Coherent vortex formation is observed below the mitral valve, with a larger anterior vortex dominating the late-diastolic phases. Some quantitative discrepancies exist between the CFD and MRI flow velocities, owing to the limitations of the MR dataset in the valve region, heart rate differences in the anatomical and velocity acquisitions, and to certain phenomena that were not simulated. The CFD results compare well with measured ranges in literature.

Computational flow modeling of the left ventricle based on in vivo MRI data: initial experience.

A combined computational fluid dynamics (CFD) and magnetic resonance imaging (MRI) methodology has been developed to simulate blood flow in heart chambers, with specific application in the present study to the human left ventricle. The proposed framework employs MRI scans of a human heart to obtain geometric data, which are then used for the CFD simulations. These latter are accomplished by geometrical modeling of the ventricle using time-resolved anatomical slices of the ventricular geometry and imposition of inflow/outflow conditions at orifices notionally representing the mitral and aortic valves. The predicted flow structure evolution and physiologically relevant flow characteristics were examined and compared to existing information. The CFD model convincingly captures the three-dimensional contraction and expansion phases of endocardial motion in the left ventricle, allowing simulation of dominant flow features, such as the vortices and swirling structures. These results were qualitatively consistent with previous physiological and clinical experiments on in vivo ventricular chambers, but the accuracy of the simulated velocities was limited largely by the anatomical shortcomings in the valve region. The study also indicated areas in which the methodology requires improvement and extension.

Combined MR imaging and CFD simulation of flow in the human descending aorta.

A combined MR and computational fluid dynamics (CFD) study is made of flow in the upper descending thoracic aorta. The aim was to investigate further the potential of CFD simulations linked to in vivo MRI scans. The three-dimensional (3D) geometrical images of the aorta and the 3D time-resolved velocity images at the entry to the domain studied were used as boundary conditions for the CFD simulations of the flow. Despite some measurement uncertainties, comparisons between simulated and measured flow structures at the exit from the domain demonstrated encouraging levels of agreement. Moreover, the CFD simulation allowed the flow structure throughout the domain to be examined in more detail, in particular the flow separation region in the distal aortic arch and its influence on the downstream flow during late systole. Additional information such as relative pressure and wall shear stress, which could not be measured via MRI, were also extracted from the simulation. The results have encouraged further applications of the methods described. J. Magn. Reson. Imaging 2001;13:699-713.

Combined MRI and CFD analysis of fully developed steady and pulsatile laminar flow through a bend.

A combined MR and computational fluid dynamics (CFD) study is made of flow in a simple phantom laboratory flow rig consisting of a 180 degree bend with straight entry and exit sections. The aim was to investigate the potential of the use of MRI-linked CFD simulations for in vivo use. To this end, the experiment was set up for both steady and pulsatile laminar flow conditions, with Reynolds and Dean numbers and Womersley pulsatility parameter representative of resting flow in the human aorta. The geometrical images of the pipe and the velocity images at entry to the bend were used as boundary conditions for CFD simulations of the flow. The CFD results for both steady and pulsatile cases compared favorably with velocity images obtained at exit from the bend. Additional information such as pressure and wall shear stress, which either could not be measured adequately via MRI, or could not be measured at all, was also extracted from the simulation. Overall, the results were sufficiently promising to justify pursuing subsequent in vivo studies.