Zablah Jenny E, Shorofsky Michael J, Cao Kelly, Mukherjee Debanjan
Children's Hospital of Colorado Heart Institute, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Biomedical Engineering, University of Colorado Boulder, Boulder, CO, USA.
Pediatr Cardiol. 2025 Feb;46(2):458-466. doi: 10.1007/s00246-024-03443-7. Epub 2024 Mar 15.
For congenital heart disease patients, multiple imaging modalities are needed to discern anatomy and functional information such as differential blood flow. During cardiac catheterization, 3D rotational angiography (3DRA) can provide CTA-like images, enabling anatomical information and intraprocedural guidance. We seek to establish whether unique aspects of this technique can also generate quantitative functional blood flow information. We propose that systematic integration of 3DRA imaging, catheter hemodynamic information, and computational fluid dynamics (CFD), can provide quantitative information regarding blood flow dynamics and energetics, without additional imaging or procedures. We report a single center retrospective feasibility study comprising four patients with 3DRA imaging and a complete set of hemodynamic data. 3DRA was processed and segmented to reconstruct vascular regions of interest (ROI), and a computational grid for CFD modeling of blood flow through the ROI was generated. Blood flow was simulated by integrating catheter hemodynamic data to devise boundary conditions at vascular ROI inlets and outlets. The 3DRA-based workflow successfully generated key computational outputs commonly used for cardiovascular applications, including flow patterns, distribution fractions, wall shear stress. Computational outputs obtained were as detailed and resolved as those obtained from more commonly used CT or MR angiography. Accuracy was confirmed by comparing computed flow distributions with measurements for 2 cases, showing less than 2.0% error from the measured data. Systematic integration of catheter hemodynamic information, 3DRA imaging, and CFD modeling, provides an effective and feasible alternative to obtain important quantitative blood flow information and visualization, without additional imaging.
对于先天性心脏病患者，需要多种成像方式来识别解剖结构和功能信息，如不同的血流情况。在心脏导管插入术中，三维旋转血管造影（3DRA）可提供类似CTA的图像，从而提供解剖信息并用于术中引导。我们试图确定该技术的独特方面是否也能生成定量的功能性血流信息。我们提出，将3DRA成像、导管血流动力学信息和计算流体动力学（CFD）进行系统整合，可提供有关血流动力学和能量学的定量信息，而无需额外的成像或操作。我们报告了一项单中心回顾性可行性研究，该研究包括四名有3DRA成像和完整血流动力学数据的患者。对3DRA进行处理和分割，以重建感兴趣的血管区域（ROI），并生成用于对通过ROI的血流进行CFD建模的计算网格。通过整合导管血流动力学数据来设计血管ROI入口和出口处的边界条件，从而模拟血流。基于3DRA的工作流程成功生成了常用于心血管应用的关键计算输出，包括血流模式、分布分数、壁面剪应力。获得的计算输出与从更常用的CT或磁共振血管造影获得的输出一样详细和清晰。通过比较2例计算出的血流分布与测量值，确认了准确性，显示与测量数据的误差小于2.0%。将导管血流动力学信息、3DRA成像和CFD建模进行系统整合，提供了一种有效且可行的替代方法，无需额外成像即可获得重要的定量血流信息和可视化结果。
