Centre for Computational Imaging and Simulation Technologies in Biomedicine (CISTIB), Information and Communication Technologies Department, Universitat Pompeu Fabra, c/Tanger 122-140, 08018 Barcelona, Spain.
Philos Trans A Math Phys Eng Sci. 2010 Jun 28;368(1921):2961-82. doi: 10.1098/rsta.2010.0095.
In the last few years, some of the visionary concepts behind the virtual physiological human began to be demonstrated on various clinical domains, showing great promise for improving healthcare management. In the current work, we provide an overview of image- and biomechanics-based techniques that, when put together, provide a patient-specific pipeline for the management of intracranial aneurysms. The derivation and subsequent integration of morphological, morphodynamic, haemodynamic and structural analyses allow us to extract patient-specific models and information from which diagnostic and prognostic descriptors can be obtained. Linking such new indices with relevant clinical events should bring new insights into the processes behind aneurysm genesis, growth and rupture. The development of techniques for modelling endovascular devices such as stents and coils allows the evaluation of alternative treatment scenarios before the intervention takes place and could also contribute to the understanding and improved design of more effective devices. A key element to facilitate the clinical take-up of all these developments is their comprehensive validation. Although a number of previously published results have shown the accuracy and robustness of individual components, further efforts should be directed to demonstrate the diagnostic and prognostic efficacy of these advanced tools through large-scale clinical trials.
在过去的几年中，虚拟生理人背后的一些有远见的概念开始在各个临床领域得到展示，为改善医疗保健管理带来了巨大的希望。在当前的工作中，我们提供了一个基于图像和生物力学技术的概述，这些技术结合在一起，为颅内动脉瘤的管理提供了一个患者特异性的管道。形态学、形态动力学、血液动力学和结构分析的推导和随后的整合，使我们能够从患者特异性模型和信息中提取出可以获得诊断和预后描述符的信息。将这些新指标与相关的临床事件联系起来，应该可以深入了解动脉瘤发生、生长和破裂背后的过程。用于模拟支架和线圈等血管内装置的技术的发展允许在干预之前评估替代治疗方案，并且还可以有助于理解和设计更有效的装置。促进所有这些发展在临床中应用的一个关键因素是它们的全面验证。尽管以前发表的一些结果已经表明了单个组件的准确性和稳健性，但还需要进一步努力通过大规模临床试验来证明这些先进工具的诊断和预后效果。
