Patient-specific 4D inlet velocity profiles demonstrated that oscillatory shear and helicity are highly sensitive to inlet velocity distribution and flow volume throughout the false lumen.
The choice of inlet velocity profile in computational fluid dynamics simulations of type-B aortic dissection significantly affects key haemodynamic indices, highlighting the importance of patient-specific 4D-flow MRI data.
Type-B aortic dissection is a cardiovascular disease in which a tear develops in the intimal layer of the descending aorta, allowing pressurized blood to delaminate the layers of the vessel wall. In medically managed patients, long-term aneurysmal dilatation of the false lumen (FL) is considered virtually inevitable and is associated with poorer disease outcomes. While the pathophysiological mechanisms driving FL dilatation are not yet understood, haemodynamic factors are believed to play a key role. Computational fluid dynamics (CFD) and 4D-flow MRI (4DMR) analyses have revealed correlations between flow helicity, oscillatory wall shear stress and aneurysmal dilatation of the FL. In this study, we compare CFD simulations using a patient-specific, three-dimensional, three-component inlet velocity profile (4D IVP) extracted from 4DMR data against simulations with flow rate-matched uniform and axial velocity profiles that remain widely used in the absence of 4DMR. We also evaluate the influence of measurement errors in 4DMR data by scaling the 4D IVP to the degree of imaging error detected in prior studies. We observe that oscillatory shear and helicity are highly sensitive to inlet velocity distribution and flow volume throughout the FL and conclude that the choice of IVP may greatly affect the future clinical value of simulations.
Stokes et al. (2023) studied Type-B aortic dissection. Patient-specific 4D inlet velocity profile (4D IVP) from 4DMR data vs. Flow rate-matched uniform and axial velocity profiles was evaluated on Oscillatory shear and helicity sensitivity. Patient-specific 4D inlet velocity profiles demonstrated that oscillatory shear and helicity are highly sensitive to inlet velocity distribution and flow volume throughout the false lumen.