@article{MartensPanzervandenWijngaardetal.2020,
  author    = {Martens, Johannes and Panzer, Sabine and van den Wijngaard, Jeroen and Siebes, Maria and Schreiber, Laura M.},
  title     = {Influence of contrast agent dispersion on bolus-based MRI myocardial perfusion measurements: A computational fluid dynamics study},
  series = {Magnetic Resonance in Medicine},
  volume    = {84},
  journal   = {Magnetic Resonance in Medicine},
  number    = {1},
  doi       = {10.1002/mrm.28125},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-208698},
  pages     = {467-483},
  year      = {2020},
  abstract  = {Purpose: Bolus-based dynamic contrast agent (CA) perfusion measurements of the heart are subject to systematic errors due to CA bolus dispersion in the coronary arteries. To better understand these effects on quantification of myocardial blood flow and myocardial perfusion reserve (MPR), an in-silico model of the coronary arteries down to the pre-arteriolar vessels has been developed. Methods: In this work, a computational fluid dynamics analysis is performed to investigate these errors on the basis of realistic 3D models of the left and right porcine coronary artery trees, including vessels at the pre-arteriolar level. Using advanced boundary conditions, simulations of blood flow and CA transport are conducted at rest and under stress. These are evaluated with regard to dispersion (assessed by the width of CA concentration time curves and associated vascular transport functions) and errors of myocardial blood flow and myocardial perfusion reserve quantification. Results: Contrast agent dispersion increases with traveled distance as well as vessel diameter, and decreases with higher flow velocities. Overall, the average myocardial blood flow errors are -28\% ± 16\% and -8.5\% ± 3.3\% at rest and stress, respectively, and the average myocardial perfusion reserve error is 26\% ± 22\%. The calculated values are different in the left and right coronary tree. Conclusion: Contrast agent dispersion is dependent on a complex interplay of several different factors characterizing the cardiovascular bed, including vessel size and integrated vascular length. Quantification errors evoked by the observed CA dispersion show nonnegligible distortion in dynamic CA bolus-based perfusion measurements. We expect future improvements of quantitative perfusion measurements to make the systematic errors described here more apparent.},
  language  = {en}
}
@phdthesis{Martens2020,
  author    = {Martens, Johannes},
  title     = {Development of an In-Silico Model of the Arterial Epicardial Vasculature},
  doi       = {10.25972/OPUS-18247},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-182478},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2020},
  abstract  = {In dynamic CE MR perfusion imaging the passage of an intravenously injected CA bolus through tissue is monitored to assess the myocardial pefusion state. To enable this, knowledge of the shape of CA wash-in through upstream epicardial vessels is required, the so-called AIF. For technical reasons this cannot be quantified directly in the supplying vessels and is thus measured in the left ventricle, which introduces the risk of systematic errors in quantification of MBF due to bolus dispersion in coronary vessels. This means occuring CA dispersion must be accounted in the quantification process in order to produce reliable and reproducible results. In order to do this, CFD simulations are performed to analyze and approximate these errors and deepen insights and knowledge gained from previous CFD analyses on both idealized as well as realistic and pathologically altered 3D geometries. In a first step, several different procedures and approaches are undertaken in order to accelerate the performed workflow, however, maintaining a sufficient degree of numerical accuracy. In the end, the implementation of these steps makes the analysis of the cardiovascular 3D model of unprecedented detail including vessels at pre-arteriolar level feasible at all. The findings of the Navier-Stokes simulations are thus validated with regard to different aspects of cardiac blood flow. These include the distribution of VBF into the different myocardial regions, the areals, which can be associated to the large coronary arteries as well as the fragmentation of VBF into vessels of different diameters. The subsequently performed CA transport simulations yield results on the one hand confirming previous studies. On the other hand, interesting additional knowledge about the behavior of CA dispersion in coronary arteries is obtained both regarding travelled distance as well as vessel diameters. The relative dispersion of the so-called vascular transport function, a characterizing feature of vascular networks, shows a linear decrease with vessel diameter. This results in asymptotically decreased additional dispersion of the CA time curve towards smaller and more distal vessels. Nonetheless, perfusion quantification errors are subject to strong regional variability and reach an average value of \$(-28\pm16)\$ \\% at rest across the whole myocardium. Depending on the distance from the inlet and the considered coronary tree, MBF errors up to 62 \\% are observed.},
  subject      = {Computerunterst{\"u}tztes Verfahren},
  language  = {en}
}