Vukicevic Arso M, Stepanovic Nemanja M, Jovicic Gordana R, Apostolovic Svetlana R, Filipovic Nenad D
Faculty of Engineering, University of Kragujevac, Sestre Janjic 6, Kragujevac, 34000, Serbia,
Med Biol Eng Comput. 2014 Jun;52(6):539-56. doi: 10.1007/s11517-014-1155-9. Epub 2014 Apr 27.
Despite a lot of progress in the fields of medical imaging and modeling, problem of estimating the risk of in-stent restenosis and monitoring the progress of the therapy following stenting still remains. The principal aim of this paper was to propose architecture and implementation details of state of the art of computer methods for a follow-up study of disease progression in coronary arteries stented with bare-metal stents. The 3D reconstruction of coronary arteries was performed by fusing X-ray angiography and intravascular ultrasound (IVUS) as the most dominant modalities in interventional cardiology. The finite element simulation of plaque progression was performed by coupling the flow equations with the reaction-diffusion equation applying realistic boundary conditions at the wall. The alignment of baseline and follow-up data was performed automatically by temporal alignment of IVUS electrocardiogram-gated frames. The assessment was performed using three six-month follow-ups of right coronary artery. Simulation results were compared with the ground truth data measured by clinicians. In all three data sets, simulation results indicated the right places as critical. With the obtained difference of 5.89 ± ~4.5% between the clinical measurements and the results of computer simulations, we showed that presented framework is suitable for tracking the progress of coronary disease, especially for comparing face-to-face results and data of the same artery from distinct time periods.
尽管医学成像和建模领域取得了很大进展，但估计支架内再狭窄风险以及监测支架置入后治疗进展的问题仍然存在。本文的主要目的是提出用于裸金属支架置入的冠状动脉疾病进展随访研究的计算机方法的最新架构和实现细节。冠状动脉的三维重建是通过融合X射线血管造影和血管内超声（IVUS）来完成的，这是介入心脏病学中最主要的方式。通过将流动方程与反应扩散方程耦合，并在壁面应用实际边界条件，对斑块进展进行有限元模拟。通过IVUS心电图门控帧的时间对齐自动完成基线数据和随访数据的对齐。使用对右冠状动脉进行的三次六个月随访进行评估。将模拟结果与临床医生测量的真实数据进行比较。在所有三个数据集中，模拟结果都表明了关键部位。临床测量与计算机模拟结果之间的差异为5.89±~4.5%，我们表明所提出的框架适用于跟踪冠状动脉疾病的进展，特别是用于比较同一动脉在不同时间段的面对面结果和数据。
