Computer aided approximation of flow rate through systemic-pulmonary arterial shunts (SPAS).

The discrimination of flow rates through bronchial arteries that are affected by pathological SPAS today still happens solely qualitatively. A reproducible quantification of flow rates, however, would enable the comprehension of phenomena like the intensified shunt perfusion seen in cases of chronic inflammations or the characterization of SPAS that may cause cardiovascular problems. A computational program is developed, that allows the modeling of individual bronchial arteries on the basis of the information provided by angiography. Angiographic images are available from the standard clinical assessment of SPAS. The flow through continuous and geometrically measurable vessel segments and SPAS is given by the law of Hagen-Poiseuille. The discharge through healthy branches is calculated by means of allometric scaling laws. The simulation results are verified by flow experiments in artificial vessel networks made of glass and PE tubing. The experimental set-up mimics realistic, pulsating pressure and flow conditions. When applied to the artificial vessel networks, the model described herein provides results for the volumetric flow rate that differ from values measured in laboratory experiments by <6%. The computer model is also applied to real angiographic images. Due to inaccuracies during the deduction of the geometry and due to necessary simplifications of the model, we expect significant deviations between calculated and real flow rates in bronchial systems. Nevertheless, the presented method enables the physician to objectively estimate the order of magnitude of volumetric flow through individual SPAS fairly independently from his experience and without the need of measurements additional to the mandatory angiography.