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基于图像的特定患者心室模型,具有用于心功能评估和手术设计优化的流固耦合作用

Image-Based Patient-Specific Ventricle Models with Fluid-Structure Interaction for Cardiac Function Assessment and Surgical Design Optimization.

作者信息

Tang Dalin, Yang Chun, Geva Tal, Del Nido Pedro J

机构信息

Mathematical Sciences Department, Worcester Polytechnic Institute, Worcester, MA 01609.

出版信息

Prog Pediatr Cardiol. 2010 Dec 1;30(1-2):51-62. doi: 10.1016/j.ppedcard.2010.09.007.

DOI:10.1016/j.ppedcard.2010.09.007
PMID:21344066
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3041970/
Abstract

Recent advances in medical imaging technology and computational modeling techniques are making it possible that patient-specific computational ventricle models be constructed and used to test surgical hypotheses and replace empirical and often risky clinical experimentation to examine the efficiency and suitability of various reconstructive procedures in diseased hearts. In this paper, we provide a brief review on recent development in ventricle modeling and its potential application in surgical planning and management of tetralogy of Fallot (ToF) patients. Aspects of data acquisition, model selection and construction, tissue material properties, ventricle layer structure and tissue fiber orientations, pressure condition, model validation and virtual surgery procedures (changing patient-specific ventricle data and perform computer simulation) were reviewed. Results from a case study using patient-specific cardiac magnetic resonance (CMR) imaging and right/left ventricle and patch (RV/LV/Patch) combination model with fluid-structure interactions (FSI) were reported. The models were used to evaluate and optimize human pulmonary valve replacement/insertion (PVR) surgical procedure and patch design and test a surgical hypothesis that PVR with small patch and aggressive scar tissue trimming in PVR surgery may lead to improved recovery of RV function and reduced stress/strain conditions in the patch area.

摘要

医学成像技术和计算建模技术的最新进展使得构建患者特异性的计算心室模型成为可能,这些模型可用于检验手术假设,并取代经验性且通常具有风险的临床实验,以研究各种心脏疾病重建手术的效率和适用性。在本文中,我们简要回顾了心室建模的最新进展及其在法洛四联症(ToF)患者手术规划和管理中的潜在应用。我们回顾了数据采集、模型选择与构建、组织材料特性、心室层结构和组织纤维方向、压力条件、模型验证以及虚拟手术程序(更改患者特异性心室数据并进行计算机模拟)等方面。报告了一项使用患者特异性心脏磁共振(CMR)成像以及具有流固相互作用(FSI)的右/左心室与补片(RV/LV/Patch)组合模型的案例研究结果。这些模型用于评估和优化人类肺动脉瓣置换/植入(PVR)手术程序和补片设计,并检验一个手术假设,即在PVR手术中使用小补片并积极修剪瘢痕组织可能会改善右心室功能恢复,并降低补片区域的应力/应变情况。

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