Joseph Christopher Muskat1, Sean Rothenberger1, Ahmadreza Baghaie1, Sameer A Ansari2, Craig Goergen1, Susanne Schnell3, Michael Markl3,4, and Vitaliy Rayz1
1Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, United States, 2Radiology, Neurological Surgery and Neurology, Northwestern University, Chicago, IL, United States, 3Radiology, Northwestern University, Chicago, IL, United States, 4Biomedical Engineering, Northwestern University, Evanston, IL, United States
Synopsis
Blood
flow in two cerebral aneurysms was measured with 4D Flow MRI and simulated with
image-based Computational Fluid Dynamics (CFD). A dual-venc 4D Flow MRI
sequence with a shared reference scan was used in addition to a standard,
single-venc 4D Flow acquisition in order to improve the dynamic range of
measured velocities. Comparison of the MRI-measured and CFD-simulated flow
fields showed that the 4D Flow and CFD methods can complement each other by
eliminating modeling errors and augmenting imaging resolution. The dual-venc 4D
Flow MRI provided valuable information on recirculating flow patterns that was
not available from the single-venc data.
Introduction:
4D Flow MRI is capable of measuring
time-resolved, 3D velocity fields in cerebral arteries. Hemodynamic forces have
been shown to affect the stability and progression of cerebral aneurysms1.
The assessment of relevant flow metrics from 4D Flow MRI may be inaccurate due
to limited spatiotemporal resolution and the dynamic range of velocities in
cerebral aneurysms. An interleaved, dual-venc 4D Flow MRI sequence with a
shared reference scan allows the acquisition of 4D Flow MRI data with high
dynamic range and without velocity aliasing2. Alternatively, these
flow parameters may be acquired from image-based Computational Fluid Dynamics
(CFD) models. While providing higher resolution, CFD relies on modeling
assumptions, which may compromise the reliability of the results. In this study,
we compared dual-venc 4D Flow with high-resolution CFD results in two cerebral
aneurysms in order to cross-validate both approaches and determine the advantages
of dual-venc 4D Flow relative to a single-venc acquisition.Methods:
Dual-venc 4D Flow MRI and a time of flight angiogram (TOF)
were acquired on a 3T MRI scanner (MAGNETOM Skyra, Siemens, Germany) in two
patients with cerebral aneurysms. The first patient (female, 65 yrs old) presented
with a saccular anterior communicating artery (ACA, 7.2 x 8.5 mm saccular)
aneurysm and the second patient (female, 60 yrs old) with a left saccular internal
carotid aneurysm (ICA, 10 mm). The TOF data was segmented to form 3D surfaces
corresponding to the luminal boundaries. Flow-related image artifacts were
corrected by comparing TOF data to the magnitude and phase images of the 4D Flow
MRI as shown in Figure 1. Numerical simulations were conducted with the solver
FLUENT, using inlet velocities prescribed from the 4D Flow data. The error in
velocity magnitude between CFD and 4D Flow MRI was determined by finding the
percentage error taking CFD as the standard for each case. The average error
with respect to all points in the region was calculated.Results:
The 4D Flow and CFD results obtained for the ICA aneurysm
are shown in Figure 1. The panel (A) shows a concave shape of the aneurysmal
dome on the TOF image due to signal saturation as well as the correct, convex
dome appearing on the 4D Flow magnitude image. The flow streamlines obtained
with the dual-venc 4D Flow (B) are compared to those obtained with CFD (C). The
image-based model of the ACA aneurysm is shown in Figure 2(A). The flow
streamlines obtained with the single-venc (B) and dual-venc 4D Flow (C) are
compared to the CFD streamlines (D). The results show the limitation of the
single-venc 4D Flow in detecting slow, recirculating patterns in the aneurysmal
sac. The dual-venc acquisition provides more details on the complex flow
patterns, while still lacking the resolution of the CFD. Error analysis of data
for the ICA aneurysm showed a 33.90% and 11.03% difference between the
dual-venc and CFD velocities in the flow recirculation and jet regions,
respectively. For the ACA aneurysm, the velocity discrepancies between the
dual-venc and CFD were 22.42% and
37.81%, while single-venc to CFD differences at the same locations were 24.93%
and 39.16%.
Discussion:
The 4D Flow data was invaluable for
correcting the segmentation errors resulting from the TOF signal loss in slow
velocity zones. In addition, the 4D Flow data was crucial for prescribing
patient-specific inlet flow conditions for the ACom aneurysm, where the flow
rates in the supplying ACAs were markedly different. The numerical results
provided information on small flow structures that were not detected with 4D
Flow. A comparison of the single-venc and dual-venc 4D Flow results for the
ACom aneurysm clearly demonstrate the advantages of the dual-venc acquisition
in detecting these slow, recirculating flow patterns. The flow field obtained
with the dual-venc captures the vortex and show the flow in the distal region
of the aneurysm. The limited improvement in the percent error calculated
between the CFD and single- and dual-venc 4D Flow data can be explained by
averaging of the velocities interpolated on lower-resolution grid. The future
work will be on quantitative comparison of velocity components and wall shear
stresses obtained with each method.Conclusions:
Comparison of the flow fields
simulated with CFD and measured with the single- and dual-venc 4D Flow MRI
showed the advantage of the dual-venc acquisition in resolving recirculating
flows in cerebral aneurysms. The study emphasized the importance of 4D Flow
measurements for verification of patient-specific CFD models as well as the
value of CFD for detecting small flow structures that affect hemodynamic forces
acting on vessel walls.Acknowledgements
No acknowledgement found.References
[1] Boussel L, Rayz V, McCulloch C, et al. Aneurysm
growth occurs at region of low wall shear stress: patient-specific correlation
of hemodynamics and growth in a longitudinal study. Stroke.
2008;39(11):2997-3002.
[2] Schnell S, Ansari S A, et al.
Accelerated dual-venc 4D flow MRI for neurovascular applications. J Magn Reson
Imaging. 2017;46(1):102-114.