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European Radiology

, Volume 22, Issue 10, pp 2094–2102 | Cite as

Haemodynamic imaging of thoracic stent-grafts by computational fluid dynamics (CFD): presentation of a patient-specific method combining magnetic resonance imaging and numerical simulations

  • Marco MidullaEmail author
  • Ramiro Moreno
  • Adil Baali
  • Ming Chau
  • Anne Negre-Salvayre
  • Franck Nicoud
  • Jean-Pierre Pruvo
  • Stephan Haulon
  • Hervé Rousseau
Vascular-Interventional

Abstract

Objectives

In the last decade, there was been increasing interest in finding imaging techniques able to provide a functional vascular imaging of the thoracic aorta. The purpose of this paper is to present an imaging method combining magnetic resonance imaging (MRI) and computational fluid dynamics (CFD) to obtain a patient-specific haemodynamic analysis of patients treated by thoracic endovascular aortic repair (TEVAR).

Methods

MRI was used to obtain boundary conditions. MR angiography (MRA) was followed by cardiac-gated cine sequences which covered the whole thoracic aorta. Phase contrast imaging provided the inlet and outlet profiles. A CFD mesh generator was used to model the arterial morphology, and wall movements were imposed according to the cine imaging. CFD runs were processed using the finite volume (FV) method assuming blood as a homogeneous Newtonian fluid.

Results

Twenty patients (14 men; mean age 62.2 years) with different aortic lesions were evaluated. Four-dimensional mapping of velocity and wall shear stress were obtained, depicting different patterns of flow (laminar, turbulent, stenosis-like) and local alterations of parietal stress in-stent and along the native aorta.

Conclusions

A computational method using a combined approach with MRI appears feasible and seems promising to provide detailed functional analysis of thoracic aorta after stent-graft implantation.

Key Points

Functional vascular imaging of the thoracic aorta offers new diagnostic opportunities

CFD can model vascular haemodynamics for clinical aortic problems

Combining CFD with MRI offers patient specific method of aortic analysis

Haemodynamic analysis of stent-grafts could improve clinical management and follow-up.

Keywords

Time-resolved 3D MRI CFD TEVAR Stent-graft Haemodynamics 

Abbreviations

MRI

Magnetic resonance imaging

CFD

Computational fluid dynamics

TEVAR

Thoracic endovascular aortic repair

MRA

Magnetic resonance angiography

PCI

Phase contrast imaging

WSS

Wall shear stress

BTFE

Balanced turbo field echo

TAA

Thoracic aortic aneurysms

PU

Penetrating ulcers

IMH

Intramural haematoma

ATAR

Acute traumatic aortic rupture

Notes

Acknowledgements

Ramiro Moreno has been financed during the development of the project by the Medtronic Vascular (Santa Rosa, CA); the project OCFIA has been supported by the French National Agency for Research (ANR 07-CIS7-006-01). CINES (Montpellier) is acknowledged for CFD calculations.

The early results of the project have been presented twice at the ECR, in 2008 and in 2011. The first presentation was honoured with the first prize in the vascular topic, of which we are sincerely proud.

Supplementary material

Video 1

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Video 2

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Video 3

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Video 4

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Video 5

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330_2012_2465_MOESM6_ESM.avi (3 mb)
Video 6a (AVI 3033 kb)
Video 6b

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Video 6c

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Video 7 (AVI 6251 kb)
330_2012_2465_MOESM10_ESM.avi (10.8 mb)
Video 8 Tetrahedral moving mesh obtained after segmentation of the aortic volume and imposition of the wall movements according to the MRI cine imaging. The approach proposed with the presented method would yield more realistic conditions for the numerical simulations and could be a further step towards patient-specific computational flow modelling via a combination of MRI with CFD (see text) (AVI 11031 kb)

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Copyright information

© European Society of Radiology 2012

Authors and Affiliations

  • Marco Midulla
    • 1
    Email author
  • Ramiro Moreno
    • 2
    • 6
  • Adil Baali
    • 6
  • Ming Chau
    • 5
  • Anne Negre-Salvayre
    • 6
  • Franck Nicoud
    • 3
  • Jean-Pierre Pruvo
    • 1
  • Stephan Haulon
    • 4
  • Hervé Rousseau
    • 2
    • 6
  1. 1.Cardiovascular RadiologyUniversity Hospital of LilleLilleFrance
  2. 2.RadiologyRangueil University HospitalToulouseFrance
  3. 3.University Montpellier II – CNRS UMR 5149 I3M, CC 051MontpellierFrance
  4. 4.Vascular SurgeryUniversity Hospital of LilleLilleFrance
  5. 5.ASA, Advanced Solutions Accelerator, University of Toulouse 3 Paul SabatierMontpellierFrance
  6. 6.INSERM/UMR 1048 Cardiovascular and Metabolic DiseasesUniversity of Toulouse 3 Paul SabatierToulouseFrance

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