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Ebel S, Kühn A, Köhler B, Behrendt B, Riekena B, Preim B, Denecke T, Grothoff M, Gutberlet M. Quantitative 4D flow MRI-derived thoracic aortic normal values of 2D flow MRI parameters in healthy volunteers. ROFO-FORTSCHR RONTG 2024; 196:273-282. [PMID: 37944940 DOI: 10.1055/a-2175-4165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
PURPOSE To utilize 4 D flow MRI to acquire normal values of "conventional 2 D flow MRI parameters" in healthy volunteers in order to replace multiple single 2 D flow measurements with a single 4 D flow acquisition. MATERIALS AND METHODS A kt-GRAPPA accelerated 4 D flow sequence was used. Flow volumes were assessed by forward (FFV), backward (BFV), and net flow volumes (NFV) [ml/heartbeat] and flow velocities by axial (VAX) and absolute velocity (VABS) [m/s] in 116 volunteers (58 females, 43 ± 13 years). The aortic regurgitant fraction (RF) was calculated. RESULTS The sex-neutral mean FFV, BFV, NFV, and RF in the ascending aorta were 93.5 ± 14.8, 3.6 ± 2.8, 89.9 ± 0.6 ml/heartbeat, and 3.9 ± 2.9 %, respectively. Significantly higher values were seen in males regarding FFV, BFV, NFV and RF, but there was no sex dependency regarding VAX and VABS. The mean maximum VAX was lower (1.01 ± 0.31 m/s) than VABS (1.23 ± 0.35 m/s). We were able to determine normal ranges for all intended parameters. CONCLUSION This study provides quantitative 4 D flow-derived thoracic aortic normal values of 2 D flow parameters in healthy volunteers. FFV, BFV, NFV, and VAX did not differ significantly from single 2 D flow acquisitions and could therefore replace time-consuming multiple single 2 D flow acquisitions. VABS should not be used interchangeably. KEY POINTS · 4 D flow MRI can be used to replace 2 D flow MRI measurements.. · The parameter absolute velocities can be assessed by 4 D flow MRI.. · There are sex-dependent differences regarding forward, backward, net aortic blood flow and the aortic valve regurgitant fraction..
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Affiliation(s)
- Sebastian Ebel
- Diagnostic and Interventional Radiology, Leipzig University, Leipzig, Germany
| | - Alexander Kühn
- Diagnostic and Interventional Radiology, Leipzig Heart Centre University Hospital, Leipzig, Germany
| | - Benjamin Köhler
- Simulation and Graphics, Otto von Guericke Universität Magdeburg, Germany
| | - Benjamin Behrendt
- Simulation and Graphics, Otto von Guericke Universität Magdeburg, Germany
| | - Boris Riekena
- Diagnostic and Interventional Radiology, Leipzig Heart Centre University Hospital, Leipzig, Germany
| | - Bernhard Preim
- Simulation and Graphics, Otto von Guericke Universität Magdeburg, Germany
| | - Timm Denecke
- Diagnostic and Interventional Radiology, Leipzig University, Leipzig, Germany
| | - Matthias Grothoff
- Diagnostic and Interventional Radiology, Leipzig Heart Centre University Hospital, Leipzig, Germany
| | - Matthias Gutberlet
- Diagnostic and Interventional Radiology, Leipzig Heart Centre University Hospital, Leipzig, Germany
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2
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Henriques J, Amaro AM, Piedade AP. Biomimicking Atherosclerotic Vessels: A Relevant and (Yet) Sub-Explored Topic. Biomimetics (Basel) 2024; 9:135. [PMID: 38534820 DOI: 10.3390/biomimetics9030135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 02/20/2024] [Accepted: 02/21/2024] [Indexed: 03/28/2024] Open
Abstract
Atherosclerosis represents the etiologic source of several cardiovascular events, including myocardial infarction, cerebrovascular accidents, and peripheral artery disease, which remain the leading cause of mortality in the world. Numerous strategies are being delineated to revert the non-optimal projections of the World Health Organization, by both designing new diagnostic and therapeutic approaches or improving the interventional procedures performed by physicians. Deeply understanding the pathological process of atherosclerosis is, therefore, mandatory to accomplish improved results in these trials. Due to their availability, reproducibility, low expensiveness, and rapid production, biomimicking physical models are preferred over animal experimentation because they can overcome some limitations, mainly related to replicability and ethical issues. Their capability to represent any atherosclerotic stage and/or plaque type makes them valuable tools to investigate hemodynamical, pharmacodynamical, and biomechanical behaviors, as well as to optimize imaging systems and, thus, obtain meaningful prospects to improve the efficacy and effectiveness of treatment on a patient-specific basis. However, the broadness of possible applications in which these biomodels can be used is associated with a wide range of tissue-mimicking materials that are selected depending on the final purpose of the model and, consequently, prioritizing some materials' properties over others. This review aims to summarize the progress in fabricating biomimicking atherosclerotic models, mainly focusing on using materials according to the intended application.
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Affiliation(s)
- Joana Henriques
- University of Coimbra, CEMMPRE, ARISE, Department of Mechanical Engineering, 3030-788 Coimbra, Portugal
| | - Ana M Amaro
- University of Coimbra, CEMMPRE, ARISE, Department of Mechanical Engineering, 3030-788 Coimbra, Portugal
| | - Ana P Piedade
- University of Coimbra, CEMMPRE, ARISE, Department of Mechanical Engineering, 3030-788 Coimbra, Portugal
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3
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Zimmermann J, Bäumler K, Loecher M, Cork TE, Marsden AL, Ennis DB, Fleischmann D. Hemodynamic effects of entry and exit tear size in aortic dissection evaluated with in vitro magnetic resonance imaging and fluid-structure interaction simulation. Sci Rep 2023; 13:22557. [PMID: 38110526 PMCID: PMC10728172 DOI: 10.1038/s41598-023-49942-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 12/13/2023] [Indexed: 12/20/2023] Open
Abstract
Understanding the complex interplay between morphologic and hemodynamic features in aortic dissection is critical for risk stratification and for the development of individualized therapy. This work evaluates the effects of entry and exit tear size on the hemodynamics in type B aortic dissection by comparing fluid-structure interaction (FSI) simulations with in vitro 4D-flow magnetic resonance imaging (MRI). A baseline patient-specific 3D-printed model and two variants with modified tear size (smaller entry tear, smaller exit tear) were embedded into a flow- and pressure-controlled setup to perform MRI as well as 12-point catheter-based pressure measurements. The same models defined the wall and fluid domains for FSI simulations, for which boundary conditions were matched with measured data. Results showed exceptionally well matched complex flow patterns between 4D-flow MRI and FSI simulations. Compared to the baseline model, false lumen flow volume decreased with either a smaller entry tear (- 17.8 and - 18.5%, for FSI simulation and 4D-flow MRI, respectively) or smaller exit tear (- 16.0 and - 17.3%). True to false lumen pressure difference (initially 11.0 and 7.9 mmHg, for FSI simulation and catheter-based pressure measurements, respectively) increased with a smaller entry tear (28.9 and 14.6 mmHg), and became negative with a smaller exit tear (- 20.6 and - 13.2 mmHg). This work establishes quantitative and qualitative effects of entry or exit tear size on hemodynamics in aortic dissection, with particularly notable impact observed on FL pressurization. FSI simulations demonstrate acceptable qualitative and quantitative agreement with flow imaging, supporting its deployment in clinical studies.
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Affiliation(s)
| | - Kathrin Bäumler
- Department of Radiology, Stanford University, Stanford, CA, USA.
| | - Michael Loecher
- Department of Radiology, Stanford University, Stanford, CA, USA
- Division of Radiology, Veterans Affairs Health Care System, Palo Alto, CA, USA
| | - Tyler E Cork
- Department of Radiology, Stanford University, Stanford, CA, USA
- Department of Bioengineering, Stanford University, Stanford, CA, USA
| | - Alison L Marsden
- Department of Bioengineering, Stanford University, Stanford, CA, USA
- Department of Pediatrics, Stanford University, Stanford, CA, USA
| | - Daniel B Ennis
- Department of Radiology, Stanford University, Stanford, CA, USA
- Division of Radiology, Veterans Affairs Health Care System, Palo Alto, CA, USA
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4
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Al Younis SM, Hadjileontiadis LJ, Stefanini C, Khandoker AH. Non-invasive technologies for heart failure, systolic and diastolic dysfunction modeling: a scoping review. Front Bioeng Biotechnol 2023; 11:1261022. [PMID: 37920244 PMCID: PMC10619666 DOI: 10.3389/fbioe.2023.1261022] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 10/09/2023] [Indexed: 11/04/2023] Open
Abstract
The growing global prevalence of heart failure (HF) necessitates innovative methods for early diagnosis and classification of myocardial dysfunction. In recent decades, non-invasive sensor-based technologies have significantly advanced cardiac care. These technologies ease research, aid in early detection, confirm hemodynamic parameters, and support clinical decision-making for assessing myocardial performance. This discussion explores validated enhancements, challenges, and future trends in heart failure and dysfunction modeling, all grounded in the use of non-invasive sensing technologies. This synthesis of methodologies addresses real-world complexities and predicts transformative shifts in cardiac assessment. A comprehensive search was performed across five databases, including PubMed, Web of Science, Scopus, IEEE Xplore, and Google Scholar, to find articles published between 2009 and March 2023. The aim was to identify research projects displaying excellence in quality assessment of their proposed methodologies, achieved through a comparative criteria-based rating approach. The intention was to pinpoint distinctive features that differentiate these projects from others with comparable objectives. The techniques identified for the diagnosis, classification, and characterization of heart failure, systolic and diastolic dysfunction encompass two primary categories. The first involves indirect interaction with the patient, such as ballistocardiogram (BCG), impedance cardiography (ICG), photoplethysmography (PPG), and electrocardiogram (ECG). These methods translate or convey the effects of myocardial activity. The second category comprises non-contact sensing setups like cardiac simulators based on imaging tools, where the manifestations of myocardial performance propagate through a medium. Contemporary non-invasive sensor-based methodologies are primarily tailored for home, remote, and continuous monitoring of myocardial performance. These techniques leverage machine learning approaches, proving encouraging outcomes. Evaluation of algorithms is centered on how clinical endpoints are selected, showing promising progress in assessing these approaches' efficacy.
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Affiliation(s)
- Sona M. Al Younis
- Department of Biomedical Engineering, Healthcare Engineering Innovation Center (HEIC), Khalifa University, Abu Dhabi, United Arab Emirates
| | - Leontios J. Hadjileontiadis
- Department of Biomedical Engineering, Healthcare Engineering Innovation Center (HEIC), Khalifa University, Abu Dhabi, United Arab Emirates
| | - Cesare Stefanini
- Creative Engineering Design Lab at the BioRobotics Institute, Applied Experimental Sciences Scuola Superiore Sant'Anna, Pontedera (Pisa), Italy
| | - Ahsan H. Khandoker
- Department of Biomedical Engineering, Healthcare Engineering Innovation Center (HEIC), Khalifa University, Abu Dhabi, United Arab Emirates
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Gill H, Fernandes JF, Nio A, Dockerill C, Shah N, Ahmed N, Raymond J, Wang S, Sotelo J, Urbina J, Uribe S, Rajani R, Rhode K, Lamata P. Aortic Stenosis: Haemodynamic Benchmark and Metric Reliability Study. J Cardiovasc Transl Res 2023; 16:862-873. [PMID: 36745287 PMCID: PMC10480252 DOI: 10.1007/s12265-022-10350-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 12/21/2022] [Indexed: 02/07/2023]
Abstract
Aortic stenosis is a condition which is fatal if left untreated. Novel quantitative imaging techniques which better characterise transvalvular pressure drops are being developed but require refinement and validation. A customisable and cost-effective workbench valve phantom circuit capable of replicating valve mechanics and pathology was created. The reproducibility and relationship of differing haemodynamic metrics were assessed from ground truth pressure data alongside imaging compatibility. The phantom met the requirements to capture ground truth pressure data alongside ultrasound and magnetic resonance image compatibility. The reproducibility was successfully tested. The robustness of three different pressure drop metrics was assessed: whilst the peak and net pressure drops provide a robust assessment of the stenotic burden in our phantom, the peak-to-peak pressure drop is a metric that is confounded by non-valvular factors such as wave reflection. The peak-to-peak pressure drop is a metric that should be reconsidered in clinical practice. The left panel shows manufacture of low cost, functional valves. The central section demonstrates circuit layout, representative MRI and US images alongside gross valve morphologies. The right panel shows the different pressure drop metrics that were assessed for reproducibility.
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Affiliation(s)
- Harminder Gill
- School of Biomedical Engineering and Imaging Sciences, King's College London, Becket House, 1 Lambeth Palace Road, SE1 7EU, London, UK.
- Cardiology Department, Guy's and St, Thomas's Hospital, London, UK.
| | - Joao Filipe Fernandes
- School of Biomedical Engineering and Imaging Sciences, King's College London, Becket House, 1 Lambeth Palace Road, SE1 7EU, London, UK
| | - Amanda Nio
- School of Biomedical Engineering and Imaging Sciences, King's College London, Becket House, 1 Lambeth Palace Road, SE1 7EU, London, UK
| | - Cameron Dockerill
- School of Biomedical Engineering and Imaging Sciences, King's College London, Becket House, 1 Lambeth Palace Road, SE1 7EU, London, UK
| | - Nili Shah
- School of Biomedical Engineering and Imaging Sciences, King's College London, Becket House, 1 Lambeth Palace Road, SE1 7EU, London, UK
| | - Naajia Ahmed
- School of Biomedical Engineering and Imaging Sciences, King's College London, Becket House, 1 Lambeth Palace Road, SE1 7EU, London, UK
| | | | - Shu Wang
- School of Biomedical Engineering and Imaging Sciences, King's College London, Becket House, 1 Lambeth Palace Road, SE1 7EU, London, UK
| | - Julio Sotelo
- School of Biomedical Engineering, Universidad de Valparaíso, Valparaíso, Chile
- Biomedical Imaging Center, Pontificia Universidad Católica de Chile, Santiago, Chile
- Millennium Institute for Intelligent Healthcare Engineering, iHEALTH, Santiago, Chile
| | - Jesus Urbina
- Biomedical Imaging Center, Pontificia Universidad Católica de Chile, Santiago, Chile
- Millennium Institute for Intelligent Healthcare Engineering, iHEALTH, Santiago, Chile
- Department of Radiology, Schools of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Sergio Uribe
- Biomedical Imaging Center, Pontificia Universidad Católica de Chile, Santiago, Chile
- Millennium Institute for Intelligent Healthcare Engineering, iHEALTH, Santiago, Chile
- Department of Radiology, Schools of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Institute for Biological and Medical Engineering, Schools of Engineering, Medicine and Biological Sciences, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Ronak Rajani
- School of Biomedical Engineering and Imaging Sciences, King's College London, Becket House, 1 Lambeth Palace Road, SE1 7EU, London, UK
- Cardiology Department, Guy's and St, Thomas's Hospital, London, UK
| | - Kawal Rhode
- School of Biomedical Engineering and Imaging Sciences, King's College London, Becket House, 1 Lambeth Palace Road, SE1 7EU, London, UK
| | - Pablo Lamata
- School of Biomedical Engineering and Imaging Sciences, King's College London, Becket House, 1 Lambeth Palace Road, SE1 7EU, London, UK
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6
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An analysis of reconstruction noise from undersampled 4D flow MRI. Biomed Signal Process Control 2023. [DOI: 10.1016/j.bspc.2023.104800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
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7
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Garay J, Mella H, Sotelo J, Cárcamo C, Uribe S, Bertoglio C, Mura J. Assessment of 4D flow MRI's quality by verifying its Navier-Stokes compatibility. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2022; 38:e3603. [PMID: 35434919 PMCID: PMC9285816 DOI: 10.1002/cnm.3603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 03/24/2022] [Accepted: 04/09/2022] [Indexed: 06/14/2023]
Abstract
4D Flow Magnetic Resonance Imaging (MRI) is the state-of-the-art technique to comprehensively measure the complex spatio-temporal and multidirectional patterns of blood flow. However, it is subject to artifacts such as noise and aliasing, which due to the 3D and dynamic structure is difficult to detect in clinical practice. In this work, a new mathematical and computational model to determine the quality of 4D Flow MRI is presented. The model is derived by assuming the true velocity satisfies the incompressible Navier-Stokes equations and that can be decomposed by the measurements u→meas plus an extra field w→ . Therefore, a non-linear problem with w→ as unknown arises, which serves as a measure of data quality. A stabilized finite element formulation tailored to this problem is proposed and analyzed. Then, extensive numerical examples-using synthetic 4D Flow MRI data as well as real measurements on experimental phantom and subjects-illustrate the ability to use w→ for assessing the quality of 4D Flow MRI measurements over space and time.
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Affiliation(s)
- Jeremías Garay
- Bernoulli InstituteUniversity of GroningenGroningenThe Netherlands
| | - Hernán Mella
- Biomedical Imaging CenterPontificia Universidad Católica de ChileSantiagoChile
- Millennium Nucleus in Cardiovascular Magnetic Resonance, Cardio MRSantiagoChile
- Department of Electrical EngineeringPontificia Universidad Católica de ChileSantiagoChile
| | - Julio Sotelo
- Biomedical Imaging CenterPontificia Universidad Católica de ChileSantiagoChile
- Millennium Nucleus in Cardiovascular Magnetic Resonance, Cardio MRSantiagoChile
- School of Biomedical EngineeringUniversidad de ValparaisoValparaisoChile
- Millennium Institute for Intelligent Healthcare Engineering, iHEALTHSantiagoChile
| | - Cristian Cárcamo
- Bernoulli InstituteUniversity of GroningenGroningenThe Netherlands
- Department of Mathematical EngineeringUniversidad de ConcepciónConcepciónChile
| | - Sergio Uribe
- Biomedical Imaging CenterPontificia Universidad Católica de ChileSantiagoChile
- Millennium Nucleus in Cardiovascular Magnetic Resonance, Cardio MRSantiagoChile
- Millennium Institute for Intelligent Healthcare Engineering, iHEALTHSantiagoChile
- Institute for Biological and Medical Engineering, Schools of Engineering, Medicine and Biological SciencesPontificia Universidad Católica de ChileSantiagoChile
- Department of Radiology, Schools of MedicinePontificia Universidad Católica de ChileSantiagoChile
| | | | - Joaquín Mura
- Millennium Nucleus in Cardiovascular Magnetic Resonance, Cardio MRSantiagoChile
- Department of Mechanical EngineeringUniversidad Técnica Federico Santa MaríaSantiagoChile
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8
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Nolte D, Urbina J, Sotelo J, Sok L, Montalba C, Valverde I, Osses A, Uribe S, Bertoglio C. Validation of 4D Flow based relative pressure maps in aortic flows. Med Image Anal 2021; 74:102195. [PMID: 34419837 DOI: 10.1016/j.media.2021.102195] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 06/11/2021] [Accepted: 07/22/2021] [Indexed: 12/18/2022]
Abstract
While the clinical gold standard for pressure difference measurements is invasive catheterization, 4D Flow MRI is a promising tool for enabling a non-invasive quantification, by linking highly spatially resolved velocity measurements with pressure differences via the incompressible Navier-Stokes equations. In this work we provide a validation and comparison with phantom and clinical patient data of pressure difference maps estimators. We compare the classical Pressure Poisson Estimator (PPE) and the new Stokes Estimator (STE) against catheter pressure measurements under a variety of stenosis severities and flow intensities. Specifically, we use several 4D Flow data sets of realistic aortic phantoms with different anatomic and hemodynamic severities and two patients with aortic coarctation. The phantom data sets are enriched by subsampling to lower resolutions, modification of the segmentation and addition of synthetic noise, in order to study the sensitivity of the pressure difference estimators to these factors. Overall, the STE method yields more accurate results than the PPE method compared to catheterization data. The superiority of the STE becomes more evident at increasing Reynolds numbers with a better capacity of capturing pressure gradients in strongly convective flow regimes. The results indicate an improved robustness of the STE method with respect to variation in lumen segmentation. However, with heuristic removal of the wall-voxels, the PPE can reach a comparable accuracy for lower Reynolds' numbers.
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Affiliation(s)
- David Nolte
- Bernoulli Institute, University of Groningen, Groningen, 9747AG, The Netherlands; Center for Mathematical Modeling, Universidad de Chile, Santiago, 8370456, Chile
| | - Jesús Urbina
- Biomedical Imaging Center, Pontificia Universidad Catolica de Chile, Santiago, 7820436, Chile; Department of Radiology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, 833002, Chile; Millennium Nucleus for Cardiovascular Magnetic Resonance, Santiago, 7820436, Chile
| | - Julio Sotelo
- Biomedical Imaging Center, Pontificia Universidad Catolica de Chile, Santiago, 7820436, Chile; Millennium Nucleus for Cardiovascular Magnetic Resonance, Santiago, 7820436, Chile; School of Biomedical Engineering, Universidad de Valparaíso, Valparaíso, Chile; Department of Electrical Engineering, Pontificia Universidad Catolica de Chile, Santiago, 7820436, Chile
| | - Leo Sok
- Bernoulli Institute, University of Groningen, Groningen, 9747AG, The Netherlands
| | - Cristian Montalba
- Biomedical Imaging Center, Pontificia Universidad Catolica de Chile, Santiago, 7820436, Chile; Millennium Nucleus for Cardiovascular Magnetic Resonance, Santiago, 7820436, Chile
| | - Israel Valverde
- Hospital Universitario Virgen del Rocío, Sevilla, 41013, Spain
| | - Axel Osses
- Center for Mathematical Modeling, Universidad de Chile, Santiago, 8370456, Chile; Millennium Nucleus for Cardiovascular Magnetic Resonance, Santiago, 7820436, Chile
| | - Sergio Uribe
- Biomedical Imaging Center, Pontificia Universidad Catolica de Chile, Santiago, 7820436, Chile; Department of Radiology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, 833002, Chile; Millennium Nucleus for Cardiovascular Magnetic Resonance, Santiago, 7820436, Chile
| | - Cristóbal Bertoglio
- Bernoulli Institute, University of Groningen, Groningen, 9747AG, The Netherlands; Center for Mathematical Modeling, Universidad de Chile, Santiago, 8370456, Chile.
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Mandell JG, Loke YH, Mass PN, Opfermann J, Cleveland V, Aslan S, Hibino N, Krieger A, Olivieri LJ. Aorta size mismatch predicts decreased exercise capacity in patients with successfully repaired coarctation of the aorta. J Thorac Cardiovasc Surg 2021; 162:183-192.e2. [PMID: 33131888 DOI: 10.1016/j.jtcvs.2020.09.103] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 09/09/2020] [Accepted: 09/18/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Coarctation of the aorta (CoA) is associated with decreased exercise capacity despite successful repair with no residual stenosis; however, the hemodynamic mechanism remains unknown. This study aims to correlate aortic arch geometry with exercise capacity in patients with successfully repaired CoA and explain hemodynamic changes using 3-dimensional-printed aorta models in a mock circulatory flow loop. METHODS A retrospective chart review identified patients with CoA repair who had cardiac magnetic resonance imaging and an exercise stress test. Measurements included aorta diameters, arch height to diameter ratio, left ventricular function, and percent descending aorta (%DAo) flow. Each aorta was printed 3-dimensionally for the flow loop. Flow and pressure were measured at the ascending aorta (AAo) and DAo during simulated rest and exercise. Measurements were correlated with percent predicted peak oxygen consumption (VO2 max). RESULTS Fifteen patients (mean age 26.8 ± 8.6 years) had a VO2 max between 47% and 126% predicted (mean 92 ± 20%) with normal left ventricular function. DAo diameter and %DAo flow positively correlated with VO2 (P = .007 and P = .04, respectively). AAo to DAo diameter ratio (DAAo/DDAo) negatively correlated with VO2 (P < .001). From flow loop simulations, the ratio of %DAo flow in exercise to rest negatively correlated with VO2 (P = .02) and positively correlated with DAAo/DDAo (P < .01). CONCLUSIONS This study suggests aorta size mismatch (DAAo/DDAo) is a novel, clinically important measurement predicting exercise capacity in patients with successful CoA repair, likely due to increased resistance and altered flow distribution. Aorta size mismatch and %DAo flow are targets for further clinical evaluation in repaired CoA.
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Affiliation(s)
- Jason G Mandell
- Division of Cardiology, Children's National Hospital, Washington, DC.
| | - Yue-Hin Loke
- Division of Cardiology, Children's National Hospital, Washington, DC
| | - Paige N Mass
- Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Hospital, Washington, DC
| | - Justin Opfermann
- Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Hospital, Washington, DC
| | - Vincent Cleveland
- Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Hospital, Washington, DC
| | - Seda Aslan
- Department of Mechanical Engineering, University of Maryland, College Park, Md
| | - Narutoshi Hibino
- Section of Cardiac Surgery, Department of Surgery, University of Chicago/Advocate Children's Hospital Chicago, Ill
| | - Axel Krieger
- Department of Mechanical Engineering, University of Maryland, College Park, Md
| | - Laura J Olivieri
- Division of Cardiology, Children's National Hospital, Washington, DC; Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Hospital, Washington, DC
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10
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On the impact of vessel wall stiffness on quantitative flow dynamics in a synthetic model of the thoracic aorta. Sci Rep 2021; 11:6703. [PMID: 33758315 PMCID: PMC7988183 DOI: 10.1038/s41598-021-86174-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 03/09/2021] [Indexed: 12/12/2022] Open
Abstract
Aortic wall stiffening is a predictive marker for morbidity in hypertensive patients. Arterial pulse wave velocity (PWV) correlates with the level of stiffness and can be derived using non-invasive 4D-flow magnetic resonance imaging (MRI). The objectives of this study were twofold: to develop subject-specific thoracic aorta models embedded into an MRI-compatible flow circuit operating under controlled physiological conditions; and to evaluate how a range of aortic wall stiffness impacts 4D-flow-based quantification of hemodynamics, particularly PWV. Three aorta models were 3D-printed using a novel photopolymer material at two compliant and one nearly rigid stiffnesses and characterized via tensile testing. Luminal pressure and 4D-flow MRI data were acquired for each model and cross-sectional net flow, peak velocities, and PWV were measured. In addition, the confounding effect of temporal resolution on all metrics was evaluated. Stiffer models resulted in increased systolic pressures (112, 116, and 133 mmHg), variations in velocity patterns, and increased peak velocities, peak flow rate, and PWV (5.8–7.3 m/s). Lower temporal resolution (20 ms down to 62.5 ms per image frame) impacted estimates of peak velocity and PWV (7.31 down to 4.77 m/s). Using compliant aorta models is essential to produce realistic flow dynamics and conditions that recapitulated in vivo hemodynamics.
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11
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Kroeger JR, Pavesio FC, Mörsdorf R, Weiss K, Bunck AC, Baeßler B, Maintz D, Giese D. Velocity quantification in 44 healthy volunteers using accelerated multi-VENC 4D flow CMR. Eur J Radiol 2021; 137:109570. [PMID: 33596498 DOI: 10.1016/j.ejrad.2021.109570] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 01/25/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND To evaluate the feasibility of a k-t accelerated multi-VENC 4D phase contrast flow MRI acquisition of the main heart-surrounding vessels, its benefits over a traditional single-VENC acquisition and to present reference flow and velocity values in a large cohort of volunteers. METHODS 44 healthy volunteers were examined on a 3 T MRI scanner (Ingenia, Philips, Best, The Netherlands). 4D flow measurements were obtained with a FOV including the aorta and the pulmonary arteries. VENC values were set to 40, 100 and 200 cm/s and unfolded based on an MRI signal model. Unfolded multi-VENC data was compared to the single-VENC with VENC 200 cm/s. Flow and velocity quantification was performed in several regions of interest (ROI) placed in the ascending aorta and in the main pulmonary artery. Conservation of mass analysis was performed for single- and multi-VENC datasets. Values for mean and maximal flow velocity and stroke volume were calculated and compared to the literature. RESULTS Mean scan time was 13.8 ± 4 min. Differences between stroke volumes between the ascending aorta and the main pulmonary artery were significantly lower in multi-VENC datasets compared to single-VENC datasets (9.6 ± 7.8 mL vs. 25.4 ± 26.4 mL, p < 0.001). This was also true for differences in stroke volume between up- and downstream ROIs in the ascending aorta and pulmonary artery. Values for mean and maximal velocities and stroke volume were in-line with previous studies. To highlight potential clinical applications two exemplary 4D flow measurements in patients with different pathologies are shown and compared to single-VENC datasets. CONCLUSIONS k-t accelerated multi-VENC 4D phase contrast flow MRI acquisition of the great vessels is feasible in a clinically acceptable scan duration. It offers improvements over traditional single-VENC 4D flow, expectedly being valuable when vessels with different flow velocities or complex flow phenomena are evaluated.
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Affiliation(s)
- Jan Robert Kroeger
- Department of Radiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany; Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital, Ruhr University Bochum, Germany.
| | - Francesca Claudia Pavesio
- Department of Radiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.
| | - Richard Mörsdorf
- Department of Radiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.
| | - Kilian Weiss
- Department of Radiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany; Philips GmbH, Hamburg, Germany.
| | - Alexander Christian Bunck
- Department of Radiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.
| | - Bettina Baeßler
- Department of Radiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany; Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland.
| | - David Maintz
- Department of Radiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.
| | - Daniel Giese
- Department of Radiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.
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12
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Bicuspid aortic valve morphology and aortic valvular outflow jets: an experimental analysis using an MRI-compatible pulsatile flow circulation system. Sci Rep 2021; 11:2066. [PMID: 33483580 PMCID: PMC7822932 DOI: 10.1038/s41598-021-81845-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 01/05/2021] [Indexed: 11/08/2022] Open
Abstract
The characteristics of aortic valvular outflow jet affect aortopathy in the bicuspid aortic valve (BAV). This study aimed to elucidate the effects of BAV morphology on the aortic valvular outflow jets. Morphotype-specific valve-devising apparatuses were developed to create aortic valve models. A magnetic resonance imaging-compatible pulsatile flow circulation system was developed to quantify the outflow jet. The eccentricity and circulation values of the peak systolic jet were compared among tricuspid aortic valve (TAV), three asymmetric BAVs, and two symmetric BAVs. The results showed mean aortic flow and leakage did not differ among the five BAVs (six samples, each). Asymmetric BAVs demonstrated the eccentric outflow jets directed to the aortic wall facing the smaller leaflets. In the asymmetric BAV with the smaller leaflet facing the right-anterior, left-posterior, and left-anterior quadrants of the aorta, the outflow jets exclusively impinged on the outer curvature of the ascending aorta, proximal arch, and the supra-valvular aortic wall, respectively. Symmetric BAVs demonstrated mildly eccentric outflow jets that did not impinge on the aortic wall. The circulation values at peak systole increased in asymmetric BAVs. The bicuspid symmetry and the position of smaller leaflet were determinant factors of the characteristics of aortic valvular outflow jet.
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13
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García-Herrera CM, Cuevas ÁA, Celentano DJ, Navarrete Á, Aranda P, Herrera E, Uribe S. Analysis of the passive biomechanical behavior of a sheep-specific aortic artery in pulsatile flow conditions. Comput Methods Biomech Biomed Engin 2021; 24:1228-1241. [PMID: 33475015 DOI: 10.1080/10255842.2021.1872549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
In this work, a novel numerical-experimental procedure is proposed, through the use of the Cardiac Simulation Test (CST), device that allows the exposure of the arterial tissue to in-vitro conditions, mimicking cardiac cycles generated by the heart. The main goal is to describe mechanical response of the arterial wall under physiological conditions, when it is subjected to a variable pressure wave over time, which causes a stress state affecting the biomechanical behavior of the artery wall. In order to get information related to stress and strain states, numerical simulation via finite element method, is performed under a condition of systolic and diastolic pressure. The description of this methodological procedure is performed with a sample corresponding to a sheep aorta without cardiovascular pathologies. There are two major findings: the evaluation of the mechanical properties of the sheep aorta through the above-mentioned tests and, the numerical simulation of the mechanical response under the conditions present in the CST. The results state that differences between numerical and experimental circumferential stretch in diastole and systole to distinct zones studied do not exceed 1%. However, greater discrepancies can be seen in the distensibility and incremental modulus, two main indicators, which are in the order of 30%. In addition, numerical results determine an increase of the principal maximum stress and strain between the case of systolic and diastolic pressure, corresponding to 31.1% and 14.9% for the stress and strain measurement respectively; where maximum values of these variables are located in the zone of the ascending aorta and the aortic arch.
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Affiliation(s)
- Claudio M García-Herrera
- Departamento de Ingeniería Mecánica, Universidad de Santiago de Chile, Santiago, Chile.,ANID - Millennium Science Initiative Program - Millennium Nucleus in Cardiovascular Magnetic Resonance, Santiago, Chile
| | - Álvaro A Cuevas
- Departamento de Ingeniería Mecánica, Universidad de Santiago de Chile, Santiago, Chile
| | - Diego J Celentano
- Departamento de Ingeniería Mecánica y Metalúrgica, Pontificia Universidad Católica, Santiago, Chile.,Radiology department and biomedical imaging center, school of medicine, Pontificia Universidad Católica de Chile
| | - Álvaro Navarrete
- Departamento de Ingeniería Mecánica, Universidad de Santiago de Chile, Santiago, Chile
| | - Pedro Aranda
- Departamento de Ingeniería Mecánica, Universidad de Santiago de Chile, Santiago, Chile
| | - Emilio Herrera
- Programa de Fisiopatología, Facultad de Medicina, Instituto de Ciencias Biomédicas, Universidad de Chile, Santiago, Chile
| | - Sergio Uribe
- Radiology department and biomedical imaging center, school of medicine, Pontificia Universidad Católica de Chile.,ANID - Millennium Science Initiative Program - Millennium Nucleus in Cardiovascular Magnetic Resonance, Santiago, Chile
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14
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Sturla F, Piatti F, Jaworek M, Lucherini F, Pluchinotta FR, Siryk SV, Giese D, Vismara R, Tasca G, Menicanti L, Redaelli A, Lombardi M. 4D Flow MRI hemodynamic benchmarking of surgical bioprosthetic valves. Magn Reson Imaging 2020; 68:18-29. [PMID: 31981709 DOI: 10.1016/j.mri.2020.01.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 12/23/2019] [Accepted: 01/19/2020] [Indexed: 11/20/2022]
Abstract
PURPOSE We exploited 4-dimensional flow magnetic resonance imaging (4D Flow), combined with a standardized in vitro setting, to establish a comprehensive benchmark for the systematic hemodynamic comparison of surgical aortic bioprosthetic valves (BPVs). MATERIALS AND METHODS 4D Flow analysis was performed on two small sizes of three commercialized pericardial BPVs (Trifecta™ GT, Carpentier-Edwards PERIMOUNT Magna and Crown PRT®). Each BPV was tested over a clinically pertinent range of continuous flow rates within an in vitro MRI-compatible system, equipped with pressure transducers. In-house 4D Flow post-processing of the post-valvular velocity field included the quantification of BPV effective orifice area (EOA), transvalvular pressure gradients (TPG), kinetic energy and viscous energy dissipation. RESULTS The 4D Flow technique effectively captured the 3-dimensional flow pattern of each device. Trifecta exhibited the lowest range of velocity and kinetic energy, maximized EOA (p < 0.0001) and minimized TPGs (p ≤ 0.015) if compared with Magna and Crown, these reporting minor EOA difference s (p ≥ 0.042) and similar TPGs (p ≥ 0.25). 4D Flow TPGs estimations strongly correlated against ground-truth data from pressure transducers; viscous energy dissipation proved to be inversely proportional to the fluid jet penetration. CONCLUSION The proposed 4D Flow analysis pinpointed consistent hemodynamic differences among BPVs, highlighting the not negligible effect of device size on the fluidynamic outcomes. The efficacy of non-invasive 4D Flow MRI protocol could shed light on how standardize the comparison among devices in relation to their actual hemodynamic performances and improve current criteria for their selection.
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Affiliation(s)
- Francesco Sturla
- 3D and Computer Simulation Laboratory, IRCCS Policlinico San Donato, San Donato Milanese, Italy.
| | - Filippo Piatti
- 3D and Computer Simulation Laboratory, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Michal Jaworek
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Federico Lucherini
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Francesca R Pluchinotta
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy; Multimodality Cardiac Imaging, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy; Department of Pediatric and Adult Congenital Heart Disease, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Sergii V Siryk
- CONCEPT Lab, Istituto Italiano di Tecnologia, Genova, Italy
| | | | - Riccardo Vismara
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Giordano Tasca
- Cardiac Surgery Unit, Heart Health Center, King Saud Medical City, Riyadh, Saudi Arabia
| | - Lorenzo Menicanti
- Department of Cardiovascular Disease, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Alberto Redaelli
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Massimo Lombardi
- Multimodality Cardiac Imaging, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
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15
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Kim J, Lee Y, Choi S, Ha H. Pulsatile flow pump based on an iterative controlled piston pump actuator as an in-vitro cardiovascular flow model. Med Eng Phys 2020; 77:118-124. [PMID: 31924498 DOI: 10.1016/j.medengphy.2019.10.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 10/02/2019] [Accepted: 10/20/2019] [Indexed: 10/25/2022]
Abstract
In-vitro cardiovascular experiments provide an effective means for characterizing structural or hemodynamic features of medical devices before they are tested on animals or used in clinical practice. In-vitro experiments simulate complicated cardiovascular systems with blood pumps, vessels and valves, but without human or animal subjects. Therefore, such experiments are free from ethical issues and present large cost savings in comparison to in-vivo experiments. In this study, we aimed to design a fully programmable pulsatile flow pump that can consistently and accurately reproduce a wide range of physiological flow waveforms without costly transient flowmeter in the system. An iterative control algorithm (ICA) was used to minimize the differences between the desired and produced flow waveforms. Our results confirm that the developed pulsatile pump can replicate flow waveforms accurately, with root mean square errors (RMSEs) of 0.64 L/min and 0.52 mL for the flow rate and stroke volume, respectively.
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Affiliation(s)
- Joonyeong Kim
- Department of Mechanical and Biomedical Engineering, Kangwon National University, Chuncheon 24341, South Korea
| | - Youngjin Lee
- Department of Mechanical and Biomedical Engineering, Kangwon National University, Chuncheon 24341, South Korea.
| | - Seongwook Choi
- Department of Mechanical and Biomedical Engineering, Kangwon National University, Chuncheon 24341, South Korea.
| | - Hoijn Ha
- Department of Mechanical and Biomedical Engineering, Kangwon National University, Chuncheon 24341, South Korea.
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16
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Carrillo H, Osses A, Uribe S, Bertoglio C. Optimal Dual-VENC Unwrapping in Phase-Contrast MRI. IEEE TRANSACTIONS ON MEDICAL IMAGING 2019; 38:1263-1270. [PMID: 30475716 DOI: 10.1109/tmi.2018.2882553] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Dual-VENC strategies have been proposed to improve the velocity-to-noise ratio in phase-contrast MRI. However, they are based on aliasing-free high-VENC data. The aim of this paper is to propose a dual-VENC velocity estimation method allowing high-VENC aliased data. For this purpose, we reformulate the phase-contrast velocity as a least squares estimator, providing a natural framework for including multiple encoding gradient measurements. By analyzing the mathematical properties of both single- and dual-VENC problems, we can justify theoretically high/low-VENC ratios such that the aliasing velocity can be minimized. The resulting reconstruction algorithm was assessed using three types of data: numerical, experimental, and volunteers. In clinical practice, this method would allow shorter examination times by avoiding tedious adaptation of VENC values by repeated scans.
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17
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Artificial Circulatory Model for Analysis of Human and Artificial Vessels. APPLIED SCIENCES-BASEL 2018. [DOI: 10.3390/app8071017] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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18
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Montalba C, Urbina J, Sotelo J, Andia ME, Tejos C, Irarrazaval P, Hurtado DE, Valverde I, Uribe S. Variability of 4D flow parameters when subjected to changes in MRI acquisition parameters using a realistic thoracic aortic phantom. Magn Reson Med 2017; 79:1882-1892. [DOI: 10.1002/mrm.26834] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 06/02/2017] [Accepted: 06/19/2017] [Indexed: 01/28/2023]
Affiliation(s)
- Cristian Montalba
- Biomedical Imaging CenterPontificia Universidad Católica de ChileSantiago Chile
| | - Jesus Urbina
- Biomedical Imaging CenterPontificia Universidad Católica de ChileSantiago Chile
- Department of RadiologySchool of Medicine, Pontificia Universidad Católica de ChileSantiago Chile
| | - Julio Sotelo
- Biomedical Imaging CenterPontificia Universidad Católica de ChileSantiago Chile
- Department of Electrical EngineeringPontificia Universidad Católica de ChileSantiago Chile
| | - Marcelo E. Andia
- Biomedical Imaging CenterPontificia Universidad Católica de ChileSantiago Chile
- Department of RadiologySchool of Medicine, Pontificia Universidad Católica de ChileSantiago Chile
| | - Cristian Tejos
- Biomedical Imaging CenterPontificia Universidad Católica de ChileSantiago Chile
- Department of Electrical EngineeringPontificia Universidad Católica de ChileSantiago Chile
| | - Pablo Irarrazaval
- Biomedical Imaging CenterPontificia Universidad Católica de ChileSantiago Chile
- Department of Electrical EngineeringPontificia Universidad Católica de ChileSantiago Chile
| | - Daniel E. Hurtado
- Department of Structural and Geotechnical EngineeringPontificia Universidad Católica de ChileSantiago Chile
- Institute for Biological and Medical EngineeringSchools of Engineering, Medicine and Biological Sciences, Pontificia Universidad Católica de ChileSantiago Chile
| | - Israel Valverde
- Hospital Virgen del RocioUniversidad de SevillaSeville Spain
- Institute of Biomedicine of SevilleUniversidad de SevillaSeville Spain
| | - Sergio Uribe
- Biomedical Imaging CenterPontificia Universidad Católica de ChileSantiago Chile
- Department of RadiologySchool of Medicine, Pontificia Universidad Católica de ChileSantiago Chile
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19
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Sotelo J, Urbina J, Valverde I, Mura J, Tejos C, Irarrazaval P, Andia ME, Hurtado DE, Uribe S. Three-dimensional quantification of vorticity and helicity from 3D cine PC-MRI using finite-element interpolations. Magn Reson Med 2017; 79:541-553. [DOI: 10.1002/mrm.26687] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 03/01/2017] [Accepted: 03/05/2017] [Indexed: 11/07/2022]
Affiliation(s)
- Julio Sotelo
- Biomedical Imaging Center; Pontificia Universidad Católica de Chile; Santiago Chile
- Department of Electrical Engineering; Pontificia Universidad Católica de Chile; Santiago Chile
- Department of Structural and Geotechnical Engineering; Pontificia Universidad Católica de Chile; Santiago Chile
| | - Jesús Urbina
- Biomedical Imaging Center; Pontificia Universidad Católica de Chile; Santiago Chile
- Department of Radiology; School of Medicine, Pontificia Universidad Católica de Chile; Santiago Chile
| | - Israel Valverde
- Pediatric Cardiology Unit; Hospital Virgen del Rocio; Sevilla Spain
- Cardiovascular Pathology Unit; Institute of Biomedicine of Seville (IBIS), Hospital Virgen del Rocio; Sevilla Spain
| | - Joaquín Mura
- Biomedical Imaging Center; Pontificia Universidad Católica de Chile; Santiago Chile
| | - Cristián Tejos
- Biomedical Imaging Center; Pontificia Universidad Católica de Chile; Santiago Chile
- Department of Electrical Engineering; Pontificia Universidad Católica de Chile; Santiago Chile
- Institute for Biological and Medical Engineering; Schools of Engineering, Medicine and Biological Sciences, Pontificia Universidad Católica de Chile; Santaigo Chile
| | - Pablo Irarrazaval
- Biomedical Imaging Center; Pontificia Universidad Católica de Chile; Santiago Chile
- Department of Electrical Engineering; Pontificia Universidad Católica de Chile; Santiago Chile
- Institute for Biological and Medical Engineering; Schools of Engineering, Medicine and Biological Sciences, Pontificia Universidad Católica de Chile; Santaigo Chile
| | - Marcelo E. Andia
- Biomedical Imaging Center; Pontificia Universidad Católica de Chile; Santiago Chile
- Department of Radiology; School of Medicine, Pontificia Universidad Católica de Chile; Santiago Chile
- Institute for Biological and Medical Engineering; Schools of Engineering, Medicine and Biological Sciences, Pontificia Universidad Católica de Chile; Santaigo Chile
| | - Daniel E. Hurtado
- Department of Structural and Geotechnical Engineering; Pontificia Universidad Católica de Chile; Santiago Chile
- Institute for Biological and Medical Engineering; Schools of Engineering, Medicine and Biological Sciences, Pontificia Universidad Católica de Chile; Santaigo Chile
| | - Sergio Uribe
- Biomedical Imaging Center; Pontificia Universidad Católica de Chile; Santiago Chile
- Department of Radiology; School of Medicine, Pontificia Universidad Católica de Chile; Santiago Chile
- Institute for Biological and Medical Engineering; Schools of Engineering, Medicine and Biological Sciences, Pontificia Universidad Católica de Chile; Santaigo Chile
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20
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Mura J, Pino AM, Sotelo J, Valverde I, Tejos C, Andia ME, Irarrazaval P, Uribe S. Enhancing the Velocity Data From 4D Flow MR Images by Reducing its Divergence. IEEE TRANSACTIONS ON MEDICAL IMAGING 2016; 35:2353-2364. [PMID: 27214892 DOI: 10.1109/tmi.2016.2570010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Velocity measurements from 4D flow MRI are prone to be affected by several imperfections of the MR system. Assuming that blood is incompressible, we propose a novel method for enhancing the velocity field by reducing its divergence. To enhance the velocity data, we added a corrector velocity to each voxel such that the divergence is minimized. The method was validated using an analytical Womersley flow model for different settings of resolution and noise levels. The performance of the proposed method was also assessed in volunteers and patients. Results demonstrated a significant reduction of the divergence depending on the size of the regularization term, obtaining a reduction close to 50% of the mean divergence with negligible modification of flow parameters. Remarkably, we found that the reduction of the divergence, in percentage, was independent of volunteers, resolution or noise.
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