Myocardial blood flow (MBF) quantification using contrast-enhanced first-pass magnetic resonance imaging relies on the precise knowledge of the arterial input function (AIF). Due to vascular transport processes, however, the shape of the AIF may change from the left ventricle where the AIF is measured to the myocardium. We employed computational fluid dynamics simulations in a realistic model of the left circumflex artery to investigate the degree to which this effect corrupts MBF quantification. Different outlet boundary conditions were applied to examine their influence on the solution. Our results indicate that vascular transport processes in realistic coronary artery geometries give rise to non-negligible systematic errors in the MBF values. The magnitude of these errors differs considerably between the outlets of the 3D model. Moreover, outlet boundary conditions are shown to have a significant influence on the outflows at the outlets of the 3D model. In particular, the employed boundary conditions respond differently to an artificially inserted stenosis and to hyperemia condition. Finally, outlet boundary conditions are shown to have an influence on the resulting MBF value. Since MBF errors are different under rest and under hyperemia conditions, overestimation of myocardial perfusion reserve values may occur as well.
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This work was supported by a Carl Zeiss Foundation Dissertation Fellowship for Karsten Sommer and by the Max Planck Graduate Center with the Johannes Gutenberg-Universität Mainz (MPGC). The authors would like to thank Mette Olufsen from the Department of Mathematics, North Carolina State University for advice regarding the efficient implementation of the structured tree model, as well as Tamás Sebestény from the Institute for Microscopic Anatomy and Neurobiology, University Medical Center Mainz for providing the corrosion cast specimen.
Conflict of Interest
No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.
Associate Editor Peter E. McHugh oversaw the review of this article.
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The supplemental video shows the transport of an injected contrast agent bolus for the resistance boundary condition without vasodilation at physical rest condition and without stenosis. For better visualization of contrast agent dispersion, a “delta bolus”, i.e., a very short version (approximately 0.5 s) of the original bolus is used as inlet boundary condition. (AVI 49033 kb)
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Sommer, K., Schmidt, R., Graafen, D. et al. Contrast Agent Bolus Dispersion in a Realistic Coronary Artery Geometry: Influence of Outlet Boundary Conditions. Ann Biomed Eng 42, 787–796 (2014) doi:10.1007/s10439-013-0950-z
- Vascular transport
- Computational fluid dynamics
- Arterial input function