Finite element modeling of lungs including interlobar fissures and the heart cavity

Role of lung lobar sliding on parenchymal distortion during breathing

Sliding between lung lobes along lobar fissures is a poorly understood aspect of lung mechanics. The objective of this study was to test the hypothesis that lobar sliding helps reduce distortion in the lung parenchyma during breathing. Finite element models of left lungs with geometries and boundary conditions derived from medical images of human subjects were developed. Effect of lobar sliding was studied by comparing nonlinear finite elastic contact mechanics simulations that allowed and disallowed lobar sliding. Lung parenchymal distortion during simulated breath-holds and tidal breathing was quantified with the model's spatial mean anisotropic deformation index (ADI), a measure of directional preference in volume change that varies spatially in the lung. Models that allowed lobar sliding had significantly lower mean ADI (i.e., lesser parenchymal distortion) than models that disallowed lobar sliding under simulations of both tidal breathing (5.3% median difference, P = 0.008, n = 8) and lung deformation between breath-holds at total lung capacity and functional residual capacity (3.2% median difference, P = 0.03, n = 6). This effect was most pronounced in the lower lobe where lobar sliding reduced parenchymal distortion with statistical significance, but not in the upper lobe. In addition, more lobar sliding was correlated with greater reduction in distortion between sliding and nonsliding models in our study cohorts (Pearson's correlation coefficient of 0.95 for tidal breathing, 0.87 for breath-holds, and 0.91 for the combined dataset). These findings are consistent with the hypothesis that lung lobar sliding reduces parenchymal distortion during breathing.NEW & NOTEWORTHY The role of lobar sliding in lung mechanics is poorly understood. Delineating this role could help explain how breathing is affected by anatomical differences between subjects such as incomplete and missing lobar fissures. We used computational contact mechanics models of lungs from human subjects to delineate the effect of lobar sliding by comparing simulations that allowed and disallowed sliding. We found evidence consistent with the hypothesis that lung lobar sliding reduces parenchymal distortion during breathing.

Integrative Computational Models of Lung Structure-Function Interactions

Anatomically based integrative models of the lung and their interaction with other key components of the respiratory system provide unique capabilities for investigating both normal and abnormal lung function. There is substantial regional variability in both structure and function within the normal lung, yet it remains capable of relatively efficient gas exchange by providing close matching of air delivery (ventilation) and blood delivery (perfusion) to regions of gas exchange tissue from the scale of the whole organ to the smallest continuous gas exchange units. This is despite remarkably different mechanisms of air and blood delivery, different fluid properties, and unique scale-dependent anatomical structures through which the blood and air are transported. This inherent heterogeneity can be exacerbated in the presence of disease or when the body is under stress. Current computational power and data availability allow for the construction of sophisticated data-driven integrative models that can mimic respiratory system structure, function, and response to intervention. Computational models do not have the same technical and ethical issues that can limit experimental studies and biomedical imaging, and if they are solidly grounded in physiology and physics they facilitate investigation of the underlying interaction between mechanisms that determine respiratory function and dysfunction, and to estimate otherwise difficult-to-access measures. © 2021 American Physiological Society. Compr Physiol 11:1501-1530, 2021.

A poroelastic model coupled to a fluid network with applications in lung modelling

We develop a lung ventilation model based on a continuum poroelastic representation of lung parenchyma that is strongly coupled to a pipe network representation of the airway tree. The continuous system of equations is discretized using a low-order stabilised finite element method. The framework is applied to a realistic lung anatomical model derived from computed tomography data and an artificially generated airway tree to model the conducting airway region. Numerical simulations produce physiologically realistic solutions and demonstrate the effect of airway constriction and reduced tissue elasticity on ventilation, tissue stress and alveolar pressure distribution. The key advantage of the model is the ability to provide insight into the mutual dependence between ventilation and deformation. This is essential when studying lung diseases, such as chronic obstructive pulmonary disease and pulmonary fibrosis. Thus the model can be used to form a better understanding of integrated lung mechanics in both the healthy and diseased states. Copyright © 2015 John Wiley & Sons, Ltd.

Contribution of serial and parallel microperfusion to spatial variability in pulmonary inter- and intra-acinar blood flow

This study presents a theoretical model of combined series and parallel perfusion in the human pulmonary acinus that maintains computational simplicity while capturing some important features of acinar structure. The model provides a transition between existing models of perfusion in the large pulmonary blood vessels and the pulmonary microcirculation. Arterioles and venules are represented as distinct elastic vessels that follow the branching structure of the acinar airways. These vessels are assumed to be joined at each generation by capillary sheets that cover the alveoli present at that generation, forming a "ladderlike" structure. Compared with a model structure in which capillary beds connect only the most distal blood vessels in the acinus, the model with combined serial and parallel perfusion provides greater capacity for increased blood flow in the lung via capillary recruitment when the blood pressure is elevated. Stratification of acinar perfusion emerges in the model, with red blood cell transit time significantly larger in the distal portion of the acinus compared with the proximal portion. This proximal-to-distal pattern of perfusion may act in concert with diffusional screening to optimize the potential for gas exchange.

Supine and prone differences in regional lung density and pleural pressure gradients in the human lung with constant shape

The explanation for prone and supine differences in tissue density and pleural pressure gradients in the healthy lung has been inferred from several studies as compression of dependent tissue by the heart in the supine posture; however, this hypothesis has not been directly confirmed. Differences could also arise from change in shape of the chest wall and diaphragm, and because of shape with respect to gravity. The contribution of this third mechanism is explored here. Tissue density and static elastic recoil were estimated in the supine and prone left human lung at functional residual capacity using a finite-element analysis. Supine model geometries were derived from multidetector row computed tomography imaging of two subjects: one normal (subject 1), and one with small airway disease (subject 2). For each subject, the prone model was the supine lung shape with gravity reversed; therefore, the prone model was isolated from the influence of displacement of the diaphragm, chest wall, or heart. Model estimates were validated against multidetector row computed tomography measurement of regional density for each subject supine and an independent study of the prone and supine lung. The magnitude of the gradient in density supine (-4.33%/cm for subject 1, and -4.96%/cm for subject 2) was nearly twice as large as for the prone lung (-2.72%/cm for subject 1, and -2.51%/cm for subject 2), consistent with measurements in dogs. The corresponding pleural pressure gradients were 0.54 cmH(2)O/cm (subject 1) and 0.56 cmH(2)O/cm (subject 2) for supine, and 0.29 cmH(2)O/cm (subject 1) and 0.27 cmH(2)O/cm (subject 2) for prone. A smaller prone gradient was predicted without shape change of the "container" or support of the heart by the lung. The influence of the heart was to constrain the shape in which the lung deformed.

An imaging-based computational approach to model ventilation distribution and soft-tissue deformation in the ovine lung

RATIONALE AND OBJECTIVES

A computational modeling framework of soft-tissue mechanics and air flow has been developed toward the aim of linking computed tomography measures of ventilation distribution to subject-specific predictions in imaging-based geometric models of the lung. The aim of this approach is to enable predictions of the effect of perturbations in geometry or functional parameters on imaged function of the lung.

MATERIALS AND METHODS

Computational techniques that can deal with anatomic detail and spatially distributed nonlinear material properties are used to model parenchymal soft-tissue mechanics in a physically realistic model of the ovine lung. The lung is modeled as a homogeneous, compressible, nonlinearly elastic body. Using equations for large deformation mechanics, change in geometry of the lung is simulated at static inflation pressures from 25 cm H2O to 0 cm H2O. Multidetector row computed tomography imaging defines the model geometry, the movement of the model lung surface during inflation, and displacement of airway bifurcations for comparison with predicted internal displacements of the model.

RESULTS

A novel modeling framework has been formulated that links equations for large deformation of the lung tissue to equations for airway flow and pressure. This preliminary model predicts airway displacements that are in good agreement with imaged displacements (total root mean square [RMS] error < 4 mm from 25 to 0 cm H2O).

CONCLUSIONS

State-of-the-art computed tomography imaging is interpreted using a modeling framework to predict ventilation distribution and changes in the geometry of the lung during increments in inflation pressure. Further development will provide a predictive link between subject-specific anatomy and function.

A biomechanical model of the upper airways for simulating laryngoscopy

This paper describes a three-dimensional finite element model of the human upper airways during rigid laryngoscopy. In this procedure, an anaesthetist uses a rigid blade to displace and compress the tongue of the patient, and then inserts a tube into the larynx to allow controlled ventilation of the lungs during an operation. A realistic model of the main biomechanical aspects involved would help anaesthetists in training and in predicting difficult cases in advance. For this purpose, the finite element method was used to model structures such as the tongue, ligaments, larynx, vocal cords, bony landmarks, laryngoscope blade, and their inter-relationships, based on data extracted from X-ray, MRI, and photographic records. The model has been used to investigate how the tongue tissue behaves in response to the insertion of the laryngoscope blade, when it is subjected to a variety of loading conditions. In particular, the mechanical behaviour of the soft tissue of the tongue was simulated, from simple linear elastic material to complex non-linear viscoelastic material. The results show that, within a specific set of tongue material parameters, the simulated outcome can be successfully related to the view of the vocal cords achieved during real laryngoscopies on normal subjects, and on artificially induced difficult laryngoscopy, created by extending the upper incisors teeth experimentally.

A possible role of the pleura in lung mechanics

The pressure-volume behavior of excised visceral pleura is studied. The pleura is modeled as a thin incompressible membrane, and the requisite membrane tension is determined from a pseudostrain-energy function. Results are compared to pressure-volume behavior of saline-filled and air-filled parenchyma and to experimental pleural data from the literature. Results suggest that the pleura may play a role as a volume limiter of lung expansion although the need for more detailed analysis is discussed.