Yevtushenko Pavlo, Goubergrits Leonid, Franke Benedikt, Kuehne Titus, Schafstedde Marie
Deutsches Herzzentrum der Charité (DHZC), Institute of Computer-assisted Cardiovascular Medicine, Berlin, Germany.
Institute for Imaging Science and Computational Modelling in Cardiovascular Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Front Cardiovasc Med. 2023 Mar 3;10:1136935. doi: 10.3389/fcvm.2023.1136935. eCollection 2023.
The computational modelling of blood flow is known to provide vital hemodynamic parameters for diagnosis and treatment-support for patients with valvular heart disease. However, most diagnosis/treatment-support solutions based on flow modelling proposed utilize time- and resource-intensive computational fluid dynamics (CFD) and are therefore difficult to implement into clinical practice. In contrast, deep learning (DL) algorithms provide results quickly with little need for computational power. Thus, modelling blood flow with DL instead of CFD may substantially enhances the usability of flow modelling-based diagnosis/treatment support in clinical routine. In this study, we propose a DL-based approach to compute pressure and wall-shear-stress (WSS) in the aorta and aortic valve of patients with aortic stenosis (AS).
A total of 103 individual surface models of the aorta and aortic valve were constructed from computed tomography data of AS patients. Based on these surface models, a total of 267 patient-specific, steady-state CFD simulations of aortic flow under various flow rates were performed. Using this simulation data, an artificial neural network (ANN) was trained to compute spatially resolved pressure and WSS using a centerline-based representation. An unseen test subset of 23 cases was used to compare both methods.
ANN and CFD-based computations agreed well with a median relative difference between both methods of 6.0% for pressure and 4.9% for wall-shear-stress. Demonstrating the ability of DL to compute clinically relevant hemodynamic parameters for AS patients, this work presents a possible solution to facilitate the introduction of modelling-based treatment support into clinical practice.
已知血流的计算建模可为心脏瓣膜病患者的诊断和治疗支持提供重要的血流动力学参数。然而,大多数基于血流建模提出的诊断/治疗支持解决方案都采用了耗时且资源密集的计算流体动力学(CFD),因此难以应用于临床实践。相比之下,深度学习(DL)算法能快速得出结果,且对计算能力需求较小。因此,用DL而非CFD对血流进行建模可能会大幅提高基于血流建模的诊断/治疗支持在临床常规中的可用性。在本研究中,我们提出一种基于DL的方法来计算主动脉瓣狭窄(AS)患者主动脉和主动脉瓣中的压力及壁面切应力(WSS)。
从AS患者的计算机断层扫描数据构建了总共103个主动脉和主动脉瓣的个体表面模型。基于这些表面模型,在不同流速下对主动脉血流进行了总共267次患者特异性的稳态CFD模拟。利用该模拟数据,训练了一个人工神经网络(ANN),以使用基于中心线的表示来计算空间分辨的压力和WSS。使用23例的一个未见过的测试子集来比较这两种方法。
ANN和基于CFD的计算结果吻合良好,两种方法之间压力的中位数相对差异为6.0%,壁面切应力为4.9%。这项工作展示了DL为AS患者计算临床相关血流动力学参数的能力,提出了一种可能的解决方案,以促进将基于建模的治疗支持引入临床实践。