Qualitative and Quantitative Assessments of Blood Flow on Tears in Type B Aortic Dissection With Different Morphologies
Objective: The interactions between aortic morphology and hemodynamics play a key role in determining type B aortic dissection (TBAD) progression and remodeling. The study aimed to provide qualitative and quantitative hemodynamic assessment in four different TBAD morphologies based on 4D flow MRI an...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2021-10-01
|
| Series: | Frontiers in Bioengineering and Biotechnology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fbioe.2021.742985/full |
| _version_ | 1818689551787360256 |
|---|---|
| author | Simone Saitta Simone Saitta Baolei Guo Selene Pirola Claudia Menichini Daqiao Guo Yan Shan Zhihui Dong Xiao Yun Xu Weiguo Fu |
| author_facet | Simone Saitta Simone Saitta Baolei Guo Selene Pirola Claudia Menichini Daqiao Guo Yan Shan Zhihui Dong Xiao Yun Xu Weiguo Fu |
| author_sort | Simone Saitta |
| collection | DOAJ |
| description | Objective: The interactions between aortic morphology and hemodynamics play a key role in determining type B aortic dissection (TBAD) progression and remodeling. The study aimed to provide qualitative and quantitative hemodynamic assessment in four different TBAD morphologies based on 4D flow MRI analysis.Materials and Methods: Four patients with different TBAD morphologies underwent CT and 4D flow MRI scans. Qualitative blood flow evaluation was performed by visualizing velocity streamlines and flow directionality near the tears. Quantitative analysis included flow rate, velocity and reverse flow index (RFI) measurements. Statistical analysis was performed to evaluate hemodynamic differences between the true lumen (TL) and false lumen (FL) of patients.Results: Qualitative analysis revealed blood flow splitting near the primary entry tears (PETs), often causing the formation of vortices in the FL. All patients exhibited clear hemodynamic differences between TL and FL, with the TL generally showing higher velocities and flow rates, and lower RFIs. Average velocity magnitude measurements were significantly different for Patient 1 (t = 5.61, p = 0.001), Patient 2 (t = 3.09, p = 0.02) and Patient 4 (t = 2.81, p = 0.03). At follow-up, Patient three suffered from left renal ischemia because of FL collapse. This patient presented a complex morphology with two FLs and marked flow differences between TL and FLs. In Patient 4, left renal artery malperfusion was observed at the 32-months follow-up, due to FL thrombosis growing after PET repair.Conclusion: The study demonstrates the clinical feasibility of using 4D flow MRI in the context of TBAD. Detailed patient-specific hemodynamics assessment before treatment may provide useful insights to better understand this pathology in the future. |
| first_indexed | 2024-12-17T12:11:55Z |
| format | Article |
| id | doaj.art-bbe4c2a52a124899b330c85b2f005801 |
| institution | Directory Open Access Journal |
| issn | 2296-4185 |
| language | English |
| last_indexed | 2024-12-17T12:11:55Z |
| publishDate | 2021-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Bioengineering and Biotechnology |
| spelling | doaj.art-bbe4c2a52a124899b330c85b2f0058012022-12-21T21:49:23ZengFrontiers Media S.A.Frontiers in Bioengineering and Biotechnology2296-41852021-10-01910.3389/fbioe.2021.742985742985Qualitative and Quantitative Assessments of Blood Flow on Tears in Type B Aortic Dissection With Different MorphologiesSimone Saitta0Simone Saitta1Baolei Guo2Selene Pirola3Claudia Menichini4Daqiao Guo5Yan Shan6Zhihui Dong7Xiao Yun Xu8Weiguo Fu9Department of Chemical Engineering, Imperial College London, London, United KingdomDepartment of Electronics Information and Bioengineering, Politecnico di Milano, Milan, ItalyDepartment of Vascular Surgery, Zhongshan Hospital, Institute of Vascular Surgery, Fudan University, Shanghai, ChinaDepartment of Chemical Engineering, Imperial College London, London, United KingdomDepartment of Chemical Engineering, Imperial College London, London, United KingdomDepartment of Vascular Surgery, Zhongshan Hospital, Institute of Vascular Surgery, Fudan University, Shanghai, ChinaDepartment of Radiology, Zhongshan Hospital, Fudan University, Shanghai, ChinaDepartment of Vascular Surgery, Zhongshan Hospital, Institute of Vascular Surgery, Fudan University, Shanghai, ChinaDepartment of Chemical Engineering, Imperial College London, London, United KingdomDepartment of Vascular Surgery, Zhongshan Hospital, Institute of Vascular Surgery, Fudan University, Shanghai, ChinaObjective: The interactions between aortic morphology and hemodynamics play a key role in determining type B aortic dissection (TBAD) progression and remodeling. The study aimed to provide qualitative and quantitative hemodynamic assessment in four different TBAD morphologies based on 4D flow MRI analysis.Materials and Methods: Four patients with different TBAD morphologies underwent CT and 4D flow MRI scans. Qualitative blood flow evaluation was performed by visualizing velocity streamlines and flow directionality near the tears. Quantitative analysis included flow rate, velocity and reverse flow index (RFI) measurements. Statistical analysis was performed to evaluate hemodynamic differences between the true lumen (TL) and false lumen (FL) of patients.Results: Qualitative analysis revealed blood flow splitting near the primary entry tears (PETs), often causing the formation of vortices in the FL. All patients exhibited clear hemodynamic differences between TL and FL, with the TL generally showing higher velocities and flow rates, and lower RFIs. Average velocity magnitude measurements were significantly different for Patient 1 (t = 5.61, p = 0.001), Patient 2 (t = 3.09, p = 0.02) and Patient 4 (t = 2.81, p = 0.03). At follow-up, Patient three suffered from left renal ischemia because of FL collapse. This patient presented a complex morphology with two FLs and marked flow differences between TL and FLs. In Patient 4, left renal artery malperfusion was observed at the 32-months follow-up, due to FL thrombosis growing after PET repair.Conclusion: The study demonstrates the clinical feasibility of using 4D flow MRI in the context of TBAD. Detailed patient-specific hemodynamics assessment before treatment may provide useful insights to better understand this pathology in the future.https://www.frontiersin.org/articles/10.3389/fbioe.2021.742985/fulltype B aortic dissection4D flow MRIaortic remodelingflow imagingthoracic endovascular aortic repair (TEVAR) |
| spellingShingle | Simone Saitta Simone Saitta Baolei Guo Selene Pirola Claudia Menichini Daqiao Guo Yan Shan Zhihui Dong Xiao Yun Xu Weiguo Fu Qualitative and Quantitative Assessments of Blood Flow on Tears in Type B Aortic Dissection With Different Morphologies Frontiers in Bioengineering and Biotechnology type B aortic dissection 4D flow MRI aortic remodeling flow imaging thoracic endovascular aortic repair (TEVAR) |
| title | Qualitative and Quantitative Assessments of Blood Flow on Tears in Type B Aortic Dissection With Different Morphologies |
| title_full | Qualitative and Quantitative Assessments of Blood Flow on Tears in Type B Aortic Dissection With Different Morphologies |
| title_fullStr | Qualitative and Quantitative Assessments of Blood Flow on Tears in Type B Aortic Dissection With Different Morphologies |
| title_full_unstemmed | Qualitative and Quantitative Assessments of Blood Flow on Tears in Type B Aortic Dissection With Different Morphologies |
| title_short | Qualitative and Quantitative Assessments of Blood Flow on Tears in Type B Aortic Dissection With Different Morphologies |
| title_sort | qualitative and quantitative assessments of blood flow on tears in type b aortic dissection with different morphologies |
| topic | type B aortic dissection 4D flow MRI aortic remodeling flow imaging thoracic endovascular aortic repair (TEVAR) |
| url | https://www.frontiersin.org/articles/10.3389/fbioe.2021.742985/full |
| work_keys_str_mv | AT simonesaitta qualitativeandquantitativeassessmentsofbloodflowontearsintypebaorticdissectionwithdifferentmorphologies AT simonesaitta qualitativeandquantitativeassessmentsofbloodflowontearsintypebaorticdissectionwithdifferentmorphologies AT baoleiguo qualitativeandquantitativeassessmentsofbloodflowontearsintypebaorticdissectionwithdifferentmorphologies AT selenepirola qualitativeandquantitativeassessmentsofbloodflowontearsintypebaorticdissectionwithdifferentmorphologies AT claudiamenichini qualitativeandquantitativeassessmentsofbloodflowontearsintypebaorticdissectionwithdifferentmorphologies AT daqiaoguo qualitativeandquantitativeassessmentsofbloodflowontearsintypebaorticdissectionwithdifferentmorphologies AT yanshan qualitativeandquantitativeassessmentsofbloodflowontearsintypebaorticdissectionwithdifferentmorphologies AT zhihuidong qualitativeandquantitativeassessmentsofbloodflowontearsintypebaorticdissectionwithdifferentmorphologies AT xiaoyunxu qualitativeandquantitativeassessmentsofbloodflowontearsintypebaorticdissectionwithdifferentmorphologies AT weiguofu qualitativeandquantitativeassessmentsofbloodflowontearsintypebaorticdissectionwithdifferentmorphologies |