Wong Kelvin K L, Wang Defeng, Ko Jacky K L, Mazumdar Jagannath, Le Thu-Thao, Ghista Dhanjoo
School of Medicine, University of Western Sydney, Campbelltown, Sydney, NSW, 2560, Australia.
School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.
Biomed Eng Online. 2017 Mar 21;16(1):35. doi: 10.1186/s12938-017-0326-y.
Cardiac dysfunction constitutes common cardiovascular health issues in the society, and has been an investigation topic of strong focus by researchers in the medical imaging community. Diagnostic modalities based on echocardiography, magnetic resonance imaging, chest radiography and computed tomography are common techniques that provide cardiovascular structural information to diagnose heart defects. However, functional information of cardiovascular flow, which can in fact be used to support the diagnosis of many cardiovascular diseases with a myriad of hemodynamics performance indicators, remains unexplored to its full potential. Some of these indicators constitute important cardiac functional parameters affecting the cardiovascular abnormalities. With the advancement of computer technology that facilitates high speed computational fluid dynamics, the realization of a support diagnostic platform of hemodynamics quantification and analysis can be achieved. This article reviews the state-of-the-art medical imaging and high fidelity multi-physics computational analyses that together enable reconstruction of cardiovascular structures and hemodynamic flow patterns within them, such as of the left ventricle (LV) and carotid bifurcations. The combined medical imaging and hemodynamic analysis enables us to study the mechanisms of cardiovascular disease-causing dysfunctions, such as how (1) cardiomyopathy causes left ventricular remodeling and loss of contractility leading to heart failure, and (2) modeling of LV construction and simulation of intra-LV hemodynamics can enable us to determine the optimum procedure of surgical ventriculation to restore its contractility and health This combined medical imaging and hemodynamics framework can potentially extend medical knowledge of cardiovascular defects and associated hemodynamic behavior and their surgical restoration, by means of an integrated medical image diagnostics and hemodynamic performance analysis framework.
心脏功能障碍是社会中常见的心血管健康问题，一直是医学成像领域研究人员高度关注的研究课题。基于超声心动图、磁共振成像、胸部X光和计算机断层扫描的诊断方法是常见的技术，可提供心血管结构信息以诊断心脏缺陷。然而，心血管血流的功能信息，实际上可用于通过众多血流动力学性能指标支持多种心血管疾病的诊断，但其全部潜力仍未得到充分探索。其中一些指标构成影响心血管异常的重要心脏功能参数。随着促进高速计算流体动力学的计算机技术的进步，可以实现血流动力学量化和分析的支持诊断平台。本文综述了最先进的医学成像和高保真多物理场计算分析，这些分析共同实现了心血管结构及其内部血流动力学流动模式的重建，如左心室（LV）和颈动脉分叉处。医学成像和血流动力学分析相结合，使我们能够研究导致心血管疾病功能障碍的机制，例如（1）心肌病如何导致左心室重塑和收缩力丧失从而导致心力衰竭，以及（2）左心室构建建模和左心室内血流动力学模拟如何使我们能够确定恢复其收缩力和健康的最佳心室手术程序。这种医学成像和血流动力学相结合的框架有可能通过综合医学图像诊断和血流动力学性能分析框架，扩展心血管缺陷及其相关血流动力学行为及其手术修复的医学知识。
