Connecting macroscopic diffusion metrics of cardiac diffusion tensor imaging and microscopic myocardial structures based on simulation.

To investigate the relationship between microscopic myocardial structures and macroscopic measurements of diffusion tensor imaging (DTI), we proposed a cardiac DTI simulation method using the Bloch equation and the Monte Carlo random walk in a realistic myocardium model reconstructed from polarized light imaging (PLI) data of the entire human heart. To obtain a realistic simulation, with the constraints of prior knowledge pertaining to the maturational change of the myocardium structure, appropriate microstructure modeling parameters were iteratively determined by matching DTI simulations and real acquisitions of the same hearts in terms of helix angle, fractional anisotropy (FA) and mean diffusivity (MD) maps. Once a realistic simulation was obtained, we varied the extra-cellular volume (ECV) ratio, myocyte orientation heterogeneity and myocyte size, and explored the effects of microscopic changes in tissue structure on macroscopic diffusion metrics.