Enhanced 4D Flow MRI-Based CFD with Adaptive Mesh Refinement for Flow Dynamics Assessment in Coarctation of the Aorta

Labib Shahid*, James Rice, Haben Berhane, Cynthia Rigsby, Joshua Robinson, Lindsay Griffin, Michael Markl, Alejandro Roldán-Alzate

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


4D Flow MRI is a diagnostic tool that can visualize and quantify patient-specific hemodynamics and help interventionalists optimize treatment strategies for repairing coarctation of the aorta (COA). Despite recent developments in 4D Flow MRI, shortcomings include phase-offset errors, limited spatiotemporal resolution, aliasing, inaccuracies due to slow aneurysmal flows, and distortion of images due to metallic artifact from vascular stents. To address these limitations, we developed a framework utilizing Computational Fluid Dynamics (CFD) with Adaptive Mesh Refinement (AMR) that enhances 4D Flow MRI visualization/quantification. We applied this framework to five pediatric patients with COA, providing in-vivo and in-silico datasets, pre- and post-intervention. These two data sets were compared and showed that CFD flow rates were within 9.6% of 4D Flow MRI, which is within a clinically acceptable range. CFD simulated slow aneurysmal flow, which MRI failed to capture due to high relative velocity encoding (Venc). CFD successfully predicted in-stent blood flow, which was not visible in the in-vivo data due to susceptibility artifact. AMR improved spatial resolution by factors of 101 to 103 and temporal resolution four-fold. This computational framework has strong potential to optimize visualization/quantification of aneurysmal and in-stent flows, improve spatiotemporal resolution, and assess hemodynamic efficiency post-COA treatment.

Original languageEnglish (US)
Pages (from-to)1001-1016
Number of pages16
JournalAnnals of Biomedical Engineering
Issue number8
StatePublished - Aug 2022


  • 4D flow MRI
  • Adaptive mesh refinement
  • Computational fluid dynamics
  • Congenital heart disease
  • Patient-specific

ASJC Scopus subject areas

  • Biomedical Engineering


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