Quantitative myocardial perfusion magnetic resonance imaging: the impact of pulsatile flow on contrast agent bolus dispersion

Myocardial blood flow (MBF) can be quantified using T1-weighted first-pass magnetic resonance imaging (MRI) in combination with a tracer-kinetic model, like MMID4. This procedure requires the knowledge of an arterial input function which is usually estimated from the left ventricle (LV). Dispersion of the contrast agent bolus may occur between the LV and the tissue of interest. The aim of this study was to investigate the dispersion under conditions of physiological pulsatile blood flow, and to simulate its effect on MBF quantification. The dispersion was simulated in coronary arteries using a computational fluid dynamics (CFD) approach. Simulations were accomplished on straight vessels with stenosis of different degrees and shapes. The results show that dispersion is more pronounced under resting conditions than during hyperemia. Stenosis leads to a reduction of dispersion. In consequence, dispersion results in a systematic MBF underestimation between -0.4% and -9.3%. The relative MBF error depends not only on the dispersion but also on the actual MBF itself. Since MBF under rest is more underestimated than under stress, myocardial perfusion reserve is overestimated between 0.1% and 4.5%. Considering other sources of errors in myocardial perfusion MRI, systematic errors of MBF by bolus dispersion are relatively small.