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

European Radiology volume 22, pages2094–2102(2012)Cite this article

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.

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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

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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.

Author information

Affiliations

  1. Cardiovascular Radiology, University Hospital of Lille, Lille, France

    Marco Midulla & Jean-Pierre Pruvo

  2. Radiology, Rangueil University Hospital, Toulouse, France

    Ramiro Moreno & Hervé Rousseau

  3. University Montpellier II – CNRS UMR 5149 I3M, CC 051, Montpellier, France

    Franck Nicoud

  4. Vascular Surgery, University Hospital of Lille, Lille, France

    Stephan Haulon

  5. ASA, Advanced Solutions Accelerator, University of Toulouse 3 Paul Sabatier, Montpellier, France

    Ming Chau

  6. INSERM/UMR 1048 Cardiovascular and Metabolic Diseases, University of Toulouse 3 Paul Sabatier, Toulouse, France

    Ramiro Moreno, Adil Baali, Anne Negre-Salvayre & Hervé Rousseau

Authors
  1. Marco Midulla
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  2. Ramiro Moreno
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  4. Ming Chau
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  7. Jean-Pierre Pruvo
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  8. Stephan Haulon
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  9. Hervé Rousseau
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Corresponding author

Correspondence to Marco Midulla.

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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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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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Midulla, M., Moreno, R., Baali, A. et al. Haemodynamic imaging of thoracic stent-grafts by computational fluid dynamics (CFD): presentation of a patient-specific method combining magnetic resonance imaging and numerical simulations. Eur Radiol 22, 2094–2102 (2012). https://doi.org/10.1007/s00330-012-2465-7

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Keywords

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