The effect of lung orientation on functional imaging of blood flow

Advancing technology has enabled rapid improvements in imaging and image processing techniques providing increasing amounts of structural and functional information. While these imaging modalities now offer a wealth of information about function within the body in health and disease certain limitations remain. We believe these can largely be addressed through a combined medical imaging - computational modeling approach. For example, imaging may only be performed in the prone or supine postures but humans function naturally in the upright position. We have developed an image-based computational model of coupled tissue mechanics and pulmonary blood flow to enable predictions of pulmonary perfusion in various postures and lung volumes. Lung and vascular geometries are derived using a combination of imaging reconstruction and computational algorithms. Solution of finite deformation equations provides predictions of tissue deformation and internal pressure distributions within the lung parenchyma. By embedding vascular models within the lung volume we obtain a coupled model of blood vessel deformation as a result of changes in lung volume. A 1D form of the Navier-Stokes flow equations are solved within the vascular model to predict perfusion. Tissue pressures calculated from the mechanics model are incorporated into the vascular constitutive pressure-radius relationship. Results demonstrated a relatively consistent flow distribution in all postures indicating the large influence of branching structure on flow distribution. It is hoped that this modeling approach may provide insights to enable interpolation of imaging measurements in alternate postures and lung volumes and enable an increased understanding of the mechanisms influencing pulmonary perfusion distribution.

[1]  R. Glenny,et al.  Vascular structure determines pulmonary blood flow distribution. , 1999, News in physiological sciences : an international journal of physiology produced jointly by the International Union of Physiological Sciences and the American Physiological Society.

[2]  E A Hoffman,et al.  Effect of body orientation on regional lung expansion: a computed tomographic approach. , 1985, Journal of applied physiology.

[3]  Andrew J. Pullan,et al.  An Anatomically Based Model of Transient Coronary Blood Flow in the Heart , 2002, SIAM J. Appl. Math..

[4]  S. Lindahl,et al.  Pulmonary perfusion is more uniform in the prone than in the supine position: scintigraphy in healthy humans. , 1999, Journal of applied physiology.

[5]  Johan Petersson,et al.  Paradoxical redistribution of pulmonary blood flow in prone and supine humans exposed to hypergravity. , 2006, Journal of applied physiology.

[6]  Merryn H. Tawhai,et al.  Computational predictions of pulmonary blood flow gradients: Gravity versus structure , 2006, Respiratory Physiology & Neurobiology.

[7]  R. Glenny,et al.  Posture primarily affects lung tissue distribution with minor effect on blood flow and ventilation , 2007, Respiratory Physiology & Neurobiology.

[8]  E. V. van Beek,et al.  The Comprehensive Imaging-Based Analysis of the Lung : A Forum for Team Science 1 , 2004 .

[9]  R W Glenny,et al.  Gravity is an important but secondary determinant of regional pulmonary blood flow in upright primates. , 1999, Journal of applied physiology.

[10]  Geoffrey McLennan,et al.  Establishing a normative atlas of the human lung: intersubject warping and registration of volumetric CT images. , 2003, Academic radiology.

[11]  R. Albert,et al.  The prone position eliminates compression of the lungs by the heart. , 2000, American journal of respiratory and critical care medicine.

[12]  P J Hunter,et al.  An anatomically based patient-specific finite element model of patella articulation: towards a diagnostic tool , 2005, Biomechanics and modeling in mechanobiology.

[13]  K. Horsfield,et al.  Morphometry of the Small Pulmonary Arteries in Man , 1978, Circulation research.

[14]  Justin W. Fernandez,et al.  Anatomically based geometric modelling of the musculo-skeletal system and other organs , 2004, Biomechanics and modeling in mechanobiology.

[15]  R. Glenny,et al.  Distributions of lung ventilation and perfusion in prone and supine humans exposed to hypergravity. , 2004, Journal of applied physiology.

[16]  Peter J Hunter,et al.  Anatomically based finite element models of the human pulmonary arterial and venous trees including supernumerary vessels. , 2005, Journal of applied physiology.

[17]  Christopher A Dawson,et al.  Flow and pressure distributions in vascular networks consisting of distensible vessels. , 2003, American journal of physiology. Heart and circulatory physiology.

[18]  Peter J Hunter,et al.  Investigation of the relative effects of vascular branching structure and gravity on pulmonary arterial blood flow heterogeneity via an image-based computational model. , 2005, Academic radiology.

[19]  John B. West,et al.  Respiratory Physiology - the Essentials , 1979 .

[20]  Y C Fung,et al.  Stress, Deformation, and Atelectasis of the Lung , 1975, Circulation research.