Agujetas R, Barrio-Perotti R, Ferrera C, Pandal-Blanco A, Walters D K, Fernández-Tena A
Departamento de Ingeniería Mecánica, Energética y de los Materiales and ICCAEx, Universidad de Extremadura, Spain.
Departamento de Energía, Universidad de Oviedo and GRUBIPU-ISPA, Spain.
Comput Methods Programs Biomed. 2020 Nov;196:105613. doi: 10.1016/j.cmpb.2020.105613. Epub 2020 Jun 20.
Health care costs represent a substantial an increasing percentage of global expenditures. One key component is treatment of respiratory diseases, which account for one in twelve deaths in Europe. Computational simulations of lung airflow have potential to provide considerable cost reduction and improved outcomes. Such simulations require accurate in silico modeling of the lung airway. The geometry of the lung is extremely complex and for this reason very simple morphologies have primarily been used to date. The objective of this work is to develop an effective methodology for the creation of hybrid pulmonary geometries combining patient-specific models obtained from CT images and idealized pulmonary models, for the purpose of carrying out experimental and numerical studies on aerosol/particle transport and deposition in inhaled drug delivery.
For the construction of the hybrid numerical model, lung images obtained from computed tomography were exported to the DICOM format to be treated with a commercial software to build the patient-specific part of the model. At the distal terminus of each airway of this portion of the model, an idealization of a single airway path is connected, extending to the sixteenth generation. Because these two parts have different endings, it is necessary to create an intermediate solid to link them together. Physically realistic treatment of truncated airway boundaries in the model was accomplished by mapping of the flow velocity distribution from corresponding conducting airway segments.
The model was verified using two sets of simulations, steady inspiration/expiration and transient simulation of forced spirometry. The results showed that the hybrid model is capable of providing a realistic description of air flow dynamics in the lung while substantially reducing computational costs relative to models of the full airway tree.
The model development outlined here represents an important step toward computational simulation of lung dynamics for patient-specific applications. Further research work may consist of investigating specific diseases, such as chronic bronchitis and pulmonary emphysema, as well as the study of the deposition of pollutants or drugs in the airways.
医疗保健成本在全球支出中所占比例相当大且呈上升趋势。其中一个关键组成部分是呼吸系统疾病的治疗,在欧洲,呼吸系统疾病导致的死亡占总死亡人数的十二分之一。肺部气流的计算模拟有潜力大幅降低成本并改善治疗效果。此类模拟需要对肺气道进行精确的计算机建模。肺部的几何形状极其复杂,因此迄今为止主要使用非常简单的形态模型。本研究的目的是开发一种有效的方法,用于创建结合从CT图像获得的患者特异性模型和理想化肺部模型的混合肺部几何模型,以便对吸入药物递送中的气溶胶/颗粒传输与沉积进行实验和数值研究。
为构建混合数值模型,将从计算机断层扫描获得的肺部图像导出为DICOM格式,以便使用商业软件进行处理,以构建模型的患者特异性部分。在该模型这一部分的每个气道的远端,连接一条单一气道路径的理想化模型,延伸至第十六代。由于这两部分有不同的末端,因此需要创建一个中间实体将它们连接在一起。通过映射来自相应传导气道段的流速分布,对模型中截断气道边界进行了符合物理实际的处理。
使用两组模拟对模型进行了验证,即稳定吸气/呼气模拟和强制肺活量测定的瞬态模拟。结果表明,该混合模型能够对肺部气流动力学提供逼真的描述,同时相对于完整气道树模型大幅降低了计算成本。
此处概述的模型开发是朝着针对患者特异性应用的肺部动力学计算模拟迈出的重要一步。进一步的研究工作可能包括研究特定疾病,如慢性支气管炎和肺气肿,以及研究污染物或药物在气道中的沉积。