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Rapid Fire Abstracts

Rapid Fire 10- Miscellaneous III

Comparison of image-based direct numerical simulations of right ventricle against 4D flow (RF_SA_477)

Saturday, February 1, 2025
11:10 AM – 11:20 AM East Coast USA Time
Location: Blue Room PreFunction
Background: Understanding right ventricular intraventricular flow dynamics is vital for managing congenital heart diseases. 4D flow MRI offers non-invasive visualization of complex blood flow but is limited by temporal and spatial resolution. Direct numerical simulations (DNS) provide high-fidelity flow representations but face uncertainties in kinematic reconstruction, geometry, and boundary conditions, particularly in modeling the tricuspid valve. To assess its clinical potential, this study compares DNS of right ventricular flow with 4D-MRI, focusing on improvements from incorporating a proposed tricuspid valve model.

Methods: A 3D model of the right heart (ventricle and atrium) from healthy control cases was developed using segmentation software (Mimics, Materialize). Wall motion was captured by tracing the endocardial border from cine stacks using Qstrain (Medis). The 3D kinematic model was generated via diffeomorphic mapping (Deformetrica). Velocity gradient fields from 4D-MRI were used to create a point cloud representing the tricuspid valve in an open configuration, and later converted into a surface using CAD software (Rhinoceros). The closed configuration was modeled as a plane. The complete 3D kinematic model, including the valve, was immersed in a Cartesian domain for direct numerical simulations across multiple cardiac cycles. Velocity profiles and Q-criterion results were used for comparison.

Results: A qualitative comparison of velocity fields between 4D-MRI and direct numerical simulations (DNS) incorporating the proposed tricuspid valve model demonstrated a strong agreement in capturing the diastolic filling of the right ventricle (Figure 1). The formation of an organized ring vortex, a critical marker of ventricular filling, beneath the tricuspid valve during early diastole was accurately captured in the presence of the tricuspid valve (Figure 2). The formation of a helical flow across the tricuspid valve is another distinct feature observed during diastolic filling (Figure 3). Although the directionality of the helical twist differs slightly from what is seen in 4D-MRI, DNS effectively captures the essential nature of the helical flow pattern.

Conclusion: The proposed DNS workflow demonstrated a strong agreement with 4D-MRI in capturing comparable flow patterns in healthy control cases. Notably, the inclusion of the tricuspid valve within the DNS model significantly enhanced its capability to capture detailed diastolic filling patterns, including the organized ring vortex, which are crucial for accurate right ventricular function assessment. By including refined IVC/SVC inflow boundary conditions and kinematic reconstruction, the future goal is to capture the diastolic filling more accurately.