Journal
MEDICAL IMAGE ANALYSIS
Volume 68, Issue -, Pages -Publisher
ELSEVIER
DOI: 10.1016/j.media.2020.101948
Keywords
Relative pressure; 4D Flow MRI; Virtual work-energy; Cardiac hemodynamics; Dynamic domains; Fluid mechanics
Categories
Funding
- Knut and Alice Wallenberg Foundation
- King's College London and Imperical College London ESPRC Centre for Doctoral Training in Medical Imaging [EP/L015226/1]
- Engineering and Physical Sciences Research Council [EP/N011554/1, EP/R003866/1]
- Wellcome Trust Senior Research Fellowship [209450/Z/17/Z]
- Swedish Research Council [2018-04454]
- Swedish Heart-Lung Foundation [2018-0657]
- Wellcome ESPRC Centre for Medical Engineering at King's College London [WT 203148/Z/16/Z]
- British Heart Foundation [TG/17/3/33406]
- NIH [R01 49039]
- Swedish Research Council [2018-04454] Funding Source: Swedish Research Council
- EPSRC [EP/R003866/1, EP/N011554/1] Funding Source: UKRI
- Vinnova [2018-04454] Funding Source: Vinnova
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The study introduces a new method vWERP for assessing intracardiac relative pressure through a virtual field, applicable in a variety of flow domains. The method is validated to be more accurate and reliable compared to alternative approaches in both simulated and clinical data.
Intracardiac blood flow is driven by differences in relative pressure, and assessing these is critical in understanding cardiac disease. Non-invasive image-based methods exist to assess relative pressure, however, the complex flow and dynamically moving fluid domain of the intracardiac space limits assessment. Recently, we proposed a method, vWERP, utilizing an auxiliary virtual field to probe relative pressure through complex, and previously inaccessible flow domains. Here we present an extension of vWERP for intracardiac flow assessments, solving the virtual field over sub-domains to effectively handle the dynamically shifting flow domain. The extended vWERP is validated in an in-silico benchmark problem, as well as in a patient-specific simulation model of the left heart, proving accurate over ranges of realistic image resolutions and noise levels, as well as superior to alternative approaches. Lastly, the extended vWERP is applied on clinically acquired 4D Flow MRI data, exhibiting realistic ventricular relative pressure patterns, as well as indicating signs of diastolic dysfunction in an exemplifying patient case. Summarized, the extended vWERP approach represents a directly applicable implementation for intracardiac flow assessments. (C) 2020 The Authors. Published by Elsevier B.V.
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