DOI QR코드

DOI QR Code

In-Vitro Model Design of Mitral Valve Regurgitation and Comparative Study of Quantification between PISA and 4D flow MRI

승모판 역류 In-Vitro 모델을 활용한 초음파 및 4D flow MRI 기반 혈류 정량화 비교연구

  • Juyeon Lee (Department of Mechanical & Biomedical Engineering, University of Kangwon) ;
  • Minseong Kwon (Department of Mechanical & Biomedical Engineering, University of Kangwon) ;
  • Hyungkyu Huh (Medical Device Development Center, Daegu Gyeongbuk Medical Innovation Foundation)
  • Received : 2024.02.21
  • Accepted : 2024.03.14
  • Published : 2024.03.31

Abstract

This study presents an in-vitro model designed to simulate mitral valve regurgitation, aiming to compare the quantification results between Proximal Isovelocity Surface Area(PISA) and 4D Flow MRI on both fixed and valve annulus tracking(VAT) views. The in-vitro model replicates the dynamic conditions of the mitral valve in a pulsatile environment, utilizing a piston pump set at 60 bpm. Through systematic experiments and analysis, the study evaluates the accuracy and effectiveness of PISA and 4D Flow MRI in assessing regurgitation severity, considering both fixed and valve annulus tracking. The displacement length measured in echo closely resembled that of optical measurements, making it advantageous for structural analysis. VAT-4D flow MRI exhibited the smallest deviation from actual flow rate values, establishing it as most accurate method for quantitative regurgitation assessment.

Keywords

Acknowledgement

This research was supported by National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIP) (NRF-2021R1C1C1003481).

References

  1. Douedi S, Steven, "Mitral regurgitation.", Europe PMC, 2020.
  2. Grayburn, Paul A., Neil J. Weissman, and Jose L. Zamorano. "Quantitation of mitral regurgitation." Circulation 126.16 (2012): 2005-2017.
  3. Apostolakis, Efstratios E., and Nikolaos G. Baikoussis. "Methods of estimation of mitral valve regurgitation for the cardiac surgeon." Journal of Cardiothoracic Surgery 4.1 (2009)
  4. Mirabel, Mariana, et al. "What are the characteristics of patients with severe, symptomatic, mitral regurgitation who are denied surgery?." European heart journal  28.11 (2007)
  5. Igata, S., Cotter, B. R., Hang, C. T., Morikawa, N., Strachan, M., Raisinghani, A., ... & DeMaria, A. N. (2021). Optimal quantification of functional mitral regurgitation: comparison of volumetric and proximal isovelocity surface area methods to predict outcome. Journal of the American Heart Association, 10(11), e018553.
  6. Papolla, Chloe, et al. "In vitro quantification of mitral regurgitation of complex geometry by the modified proximal isovelocity surface area method." Journal of the American Society of Echocardiography 33.7 (2020): 838-847.
  7. Hagendorff, Andreas, et al. "Echocardiographic assessment of mitral regurgitation: discussion of practical and methodologic aspects of severity quantification to improve diagnostic conclusiveness." Clinical Research in Cardiology (2021): 1-30.
  8. Lee, Jeesoo, et al. "Impact of assuming a circular orifice on flow error through elliptical regurgitant orifices: computational fluid dynamics and in vitro analysis of proximal flow convergence." The International Journal of Cardiovascular Imaging 39.2 (2023): 307-318.
  9. Blanken, C.P., Westenberg, J. J., Aben, J. P., Bijvoet, G.P., Chamuleau, S. A., Boekholdt, S. M., .& Planken, R. N. (2020). Quantification of mitral valve regurgitation from 4D flow MRI using semiautomated flow tracking. Radiology: Cardiothoracic Imaging, 2(5), e200004.
  10. Kwon, M., S. Park, and H. Huh. "4D flow MRI based flow visualization and quantification of bicuspid valvular flow using ex-vivo porcine model." Journal of The Korean Society of Visualization 21.1 (2023): 12-17.
  11. Fidock, Benjamin, et al. "Standard and emerging CMR methods for mitral regurgitation quantification." International Journal of Cardiology, 331, 316-321, 2021.
  12. Fidock, Benjamin, et al. "A systematic review of 4D-flow MRI derived mitral regurgitation quantification methods." Frontiers in cardiovascular medicine 6 (2019): 103.
  13. Crandon, Saul, et al. "Clinical applications of intra-cardiac four-dimensional flow cardiovascular magnetic resonance: a systematic review." International journal of cardiology 249 (2017): 486-493.
  14. Blanken, Carmen PS, et al. "Quantification of mitral valve regurgitation from 4D flow MRI using semiautomated flow tracking." Radiology: Cardiothoracic Imaging 2.5 (2020): e200004.
  15. Zoghbi, William A., et al. "Recommendations for noninvasive evaluation of native valvular regurgitation: a report from the American Society of Echocardiography developed in collaboration with the Society for Cardiovascular Magnetic Resonance." Journal of the American Society of Echocardiography 30.4 (2017): 303-371.
  16. Ballester, Miguel Angel Gonzalez, Andrew P. Zisserman, and Michael Brady. "Estimation of the partial volume effect in MRI." Medical image analysis 6.4 (2002): 389-405.
  17. Grande-Barreto, Jonas, Maria Del Pilar, and Puebla Tonantzintla. "Partial Volume Segmentation in Magnetic Resonance Imaging (MRI)." (2020).
  18. Hagendorff, Andreas, et al. "Echocardiographic assessment of mitral regurgitation: discussion of practical and methodologic aspects of severity quantification to improve diagnostic conclusiveness." Clinical Research in Cardiology (2021): 1-30.
  19. Spampinato, Ricardo A., et al. "Quantification of regurgitation in mitral valve prolapse with four-dimensional flow cardiovascular magnetic resonance." Journal of Cardiovascular Magnetic Resonance 23 (2021): 1-12.