CN105708545B - Clinical intelligence transcutaneous laser myocardial blood transport reconstruction laser duct parameter calculation apparatus - Google Patents

Clinical intelligence transcutaneous laser myocardial blood transport reconstruction laser duct parameter calculation apparatus Download PDF

Info

Publication number
CN105708545B
CN105708545B CN201610178512.6A CN201610178512A CN105708545B CN 105708545 B CN105708545 B CN 105708545B CN 201610178512 A CN201610178512 A CN 201610178512A CN 105708545 B CN105708545 B CN 105708545B
Authority
CN
China
Prior art keywords
laser
duct
grid
depth
processing module
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Active
Application number
CN201610178512.6A
Other languages
Chinese (zh)
Other versions
CN105708545A (en
Inventor
郭树理
韩丽娜
司全金
李铁岭
牛前犇
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Chinese PLA General Hospital
Beijing Institute of Technology BIT
Original Assignee
Chinese PLA General Hospital
Beijing Institute of Technology BIT
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Chinese PLA General Hospital, Beijing Institute of Technology BIT filed Critical Chinese PLA General Hospital
Priority to CN201610178512.6A priority Critical patent/CN105708545B/en
Publication of CN105708545A publication Critical patent/CN105708545A/en
Application granted granted Critical
Publication of CN105708545B publication Critical patent/CN105708545B/en
Active legal-status Critical Current
Anticipated expiration legal-status Critical

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00345—Vascular system
    • A61B2018/00351—Heart
    • A61B2018/00392—Transmyocardial revascularisation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00613—Irreversible electroporation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
    • A61B2018/2015—Miscellaneous features
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
    • A61B2018/2015—Miscellaneous features
    • A61B2018/202—Laser enclosed in a hand-piece

Landscapes

  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Physics & Mathematics (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Medical Informatics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Electromagnetism (AREA)
  • Optics & Photonics (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Otolaryngology (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Laser Surgery Devices (AREA)
  • Radiation-Therapy Devices (AREA)

Abstract

The invention discloses a kind of clinical intelligent transcutaneous laser myocardial blood transport reconstruction laser duct parameter calculation apparatus.It being capable of parameters such as position, quantity, depth, aperture and the energy in laser duct during global optimization transcutaneous laser myocardial blood transport reconstruction using the present invention, with when meeting ischemic myocardium perfusion, myocardium laser duct number is minimum, it is uniformly distributed, and to the smallest effect of laser duct surrounding myocardium thermal damage.Ischemic area and required total blood flow range of the computing device of the present invention to determining cardiac muscular tissue, grid dividing is carried out to the ischemic area of cardiac muscular tissue, then it is directed to each grid, position, quantity, laser energy, the duct for calculating laser duct generate the parameters such as time, the depth in laser duct and aperture, and give optimization method.

Description

Clinical intelligence transcutaneous laser myocardial blood transport reconstruction laser duct parameter calculation apparatus
Technical field
The present invention relates to technical field of medical information, and in particular to a kind of clinical intelligent transcutaneous laser myocardial blood transport reconstruction is sharp Unthreaded hole road parameter calculation apparatus.
Background technique
Coronary cardiopathy (Coronary heart disease) is the most common body illness of mid-aged population One of, also known as coronary heart disease.In the past 50 years, worldwide disease incidence persistently increases coronary heart disease, becomes main dead former One of because, and morbidity crowd has rejuvenation trend.80% patients with coronary heart disease is dynamic using traditional drug therapy, percutaneous coronary The modes such as arteries and veins transluminal angioplasty (PTCA) and Coronary Artery Bypass Grafting (CABG) alleviate itself symptom.But it is right Advanced stage complexity case after diffusivity Coronary Artery Lesions, Small vessel, distal end lesion and multiple PTCA or CABG, Yi Jishu The cases such as after-poppet or reangiostenosis, above-mentioned treatment method are often difficult to prove effective, and therefore, how to carry out to above-mentioned complicated case Effective treatment, becomes an important topic of medicine and field of pathology.
Since 20th century, laser science technology is grown rapidly, and many scholars begin trying laser technology being applied to clinic Medicine.1981, Mirhoscini etc. was by the coronary artery ligation of experimental dogs, then using carbon dioxide laser in its left ventricle Many laser ducts are established between chamber and cardiac muscle, it is intended to restore the myocardial ischemia region of experimental dogs, the survival rate of final experimental dogs Discovery when dissection checks is carried out to the experimental dogs of some survivals more than 70%, and after surgery, the laser duct of foundation is unobstructed simultaneously Endothelialization.Laser myocardial revascularization is divided into external membrane of heart irradiation and irradiates with the internal membrane of heart.External membrane of heart irradiation is also known as through chest laser Revascularization method (Trans myocardial Laser Revascularization, TMLR).The advantages of this method is pair The accurate positioning in laser duct will not cause to damage to coronary artery, be easier to judge laser duct effect；But it also has Itself the shortcomings that, can cause biggish damage such as due to needing to open thoracic cavity to body, and the penetrability laser hole established It is more that road will lead to bleeding.Internal membrane of heart irradiation is also known as transcutaneous laser revascularization method (Percutaneous Myocardial Laser Revascularization, PMLR), it is a kind of new hat to grow up on the basis of external membrane of heart irradiation Heart trouble interventional therapeutic technique.Compared with TMLR, PMLR not only can be to avoid PTCA and CABG postoperative support or reangiostenosis, also Has not open many advantages, such as chest, damage is small, recovery is fast, health care costs are few；But not accurate enough fibre-optic catheter positioning is the technology The part for also needing to further increase.
Ideal laser type is the laser of quasi-molecule class at present, such as carbon dioxide laser, Nd:YAG laser, Ho:YAG laser etc..The heat that this laser generates can be absorbed by tissue rapidly, be that tissue temperature raising vaporizes, formed The relatively smooth laser duct in surface, and non-carbonized layer and coagulation necrosis.Clinically used laser parameter is every time 2 arteries and veins Punching, each pulsed laser output energy 2J, power 3.5W, pulsewidth 200us, laser channel diameter about 1.0mm, laser duct depth About 5.0~6.0mm, punching number depend on the area in ischemic myocardium region, such as: left main coronary artery lesions are merged Left anterior descending branch chronic total occlusion punches 20 or so.
At abroad, nineteen sixty-five Sen etc. with regard to using needle point method carry out zoopery, between the left ventricular cavity and cardiac muscle of experimental dogs Many ducts are established, and confirm that duct has protective effect to the cardiac muscle after dog infraction, can effectively improve the ischemic shape of cardiac muscle Condition.January nineteen ninety, Crew etc. individually use high power (800W) CO global for the first time2Laser is to 1 83 years old advanced age coronary disease Patient has carried out PMLR operation in heartbeat, and after operation, the angina pectoris of patient disappears, other function of heart Can also be improved significantly.The food and Drug Administration (FDA) in the U.S. are in 1990~1996 years by multiple researchs The heart is to high power CO2Laser TMLR is up to observation in 6 years, finally has approved the clinical application of TMLR.China follows world TMLR closely Trend, in the clinic and basic research for successfully carrying out TMLR at the end of the 20th century.Provincial Hospital and conjunction work are big, Capital Medical University, southwest hospital of Third Military Medical University, Beijing 301 Hospital and Hospital No.1 Attached to Zhongsha Medical Science Univ. etc. also carry out TMLR A series of clinical research, has all obtained ideal result.
In PMLR surgical procedure, the hemoperfusion ability in the laser duct established will will have a direct impact on the treatment of operation Effect, and in Hemodynamics, laser hole is described with the blood flow flowed through at a certain section in laser duct in the unit time Perfusion ability of the road to ischemic myocardial tissue.The influence factor in aperture and duct depth for laser duct has the defeated of laser Power, the spot radius of laser beam and laser pulse duration etc. out, in addition, the optical characteristics of cardiac muscular tissue itself is joined Number, density, the latent heat of vaporization, the thermal diffusivity of specific heat and tissue and thermal conductivity etc. also have a certain impact to it.In practical mistake Cheng Zhong, also has partial heat that can cause thermal damage to tissue, and the degree of thermal damage will directly influence the effect of operation.But mesh Preceding is all that doctor empirically determines, subjective, as a result than more conservative.
Summary of the invention
In view of this, the present invention provides a kind of clinical intelligent transcutaneous laser myocardial blood transport reconstruction laser duct parameters to calculate Device, being capable of punch position, quantity, depth, aperture and energy, tool during global optimization transcutaneous laser myocardial blood transport reconstruction Have when meeting ischemic myocardium perfusion, transmyocardial revascularization number is minimum, is uniformly distributed, and to laser boring surrounding myocardium heat waste Hurt the smallest effect.
Clinic intelligent transcutaneous laser myocardial blood transport reconstruction laser duct parameter calculation apparatus of the invention, including processing mould Block,
The processing module is according to the thickness of myocardial wall, using bounded member or FInite Element to identified cardiac muscular tissue Ischemic area carries out grid dividing, the cardiac muscular tissue within the scope of certain thickness is divided in the same grid, and to all nets Lattice are numbered；Record the thickness range of each net region myocardium wall；
The processing module determines laser duct position: being directed to each grid, it is first determined first laser duct Position is grid element center flesh wall thickest part, and the spacing between laser duct is 1cm；Wherein, corresponding to the position in laser duct Myocardial wall echocardiography diastole thickness be greater than or equal to 8mm；Primarily determine the output power P of laser；
The processing module is directed to present laser duct i, when determining the duct generation in present laser duct according to formula (1) Between ti,
Wherein, P is the output power of laser；t0For from Laser emission to cardiac muscular tissue because vaporization takes place in laser action Time experienced；ρ is the density of cardiac muscular tissue；Q is the heat of vaporization of cardiac muscular tissue；C is the specific heat of cardiac muscular tissue；λ is laser Wavelength；ziFor the depth in i-th of laser duct, wherein the residual myocardium wall thickness in laser duct is more than or equal to 4mm；ω0For zi The waist radius of Gaussian beam at=0；
The processing module generates time t using determining ducti, the threshold power of laser is calculated using formula (2) Pc,i；
Wherein, k is thermal diffusivity；
The threshold power P obtained will be calculatedc,iIt is compared with laser output power P, if P < Pc,i, then laser is tuned up Output power, recalculate duct generate the time, until P >=Pc,i；
The processing module generates time t according to finally determining laser output power P and ducti, true using formula (3) The aperture d in settled preceding laser ducti；
Wherein, μaIt is cardiac muscular tissue to the absorption coefficient of laser；ω be Gaussian beam in cardiac muscle any depth it is with a tight waist Radius；
If diIn the pore diameter range of setting, then processing module determines the filling in present laser duct according to formula (4) Fluence Vi, after otherwise increasing the depth in laser duct, recalculate duct and generate time and threshold power Pc,i, until P >=Pc,i And diIn the pore diameter range of setting；If the depth in laser duct has reached the maximum value, i.e. residual myocardium wall thickness is 4mm, then maximum laser duct depth is the depth in final laser duct；
Wherein, the groundwater increment V in present laser ductiAre as follows:
Wherein, Δ p is left indoor pressure, and η is blood viscosity；
If ViWithin the scope of the groundwater increment in the single laser duct of setting, then above-mentioned finally determining laser duct position, Laser output power P, hole depth ziWith aperture diThe as parameter in i-th of laser duct；Otherwise, laser output work is chosen again After rate P, the parameter in i-th of laser duct is redefined；
The accumulation groundwater increment V that the processing module punches preceding i laser ducti,sumWith needed for identified ischemic myocardium The maximum value of total blood flowIt is compared, ifThen determine the parameter in next laser duct, wherein next The position in a laser duct are as follows: with present laser duct interval 1cm；IfThen terminate the calculating of laser duct parameter.
Preferably, for the processing module in grid dividing, maximum cardiac muscle is arranged in the net region in each grid element center At wall thickness.
Further, it is bent to carry out non-unified Rational B-splines to ischemic myocardium first in grid dividing for the processing module Then face fitting carries out grid dividing to structural model using mapping mode, the network of mixed type is selected, to the big deformation heart Flesh is based on hexahedral element；Irregular area cardiac muscle is optimized using tetrahedral grid, finally by the heart within the scope of certain thickness Muscular tissue is divided in the same grid.
Preferably, the processing module determines next along clockwise direction when determining the position in next laser duct The position in a laser duct, until there is laser duct on the ischemic myocardium in all grids.
The utility model has the advantages that
Computing device of the present invention compares prior art, can beat during global optimization transcutaneous laser myocardial blood transport reconstruction Hole site, quantity, depth, aperture, energy have when meeting ischemic myocardium perfusion, and myocardium laser duct number is minimum, It is uniformly distributed, and to the smallest effect of laser duct surrounding myocardium thermal damage.Myocardial surface laser duct number is as few as possible, reason By above mean to cardiac muscle secondary insult can be smaller；Laser duct is evenly distributed in myocardial surface, ensures microcirculation.
Detailed description of the invention
Fig. 1 is the calculation flow chart of computing device of the present invention.
Specific embodiment
The present invention will now be described in detail with reference to the accompanying drawings and examples.
It is described the present invention provides a kind of clinical intelligent transcutaneous laser myocardial blood transport reconstruction laser duct parameter calculation apparatus Computing device includes processing module, and the processing module is calculated using following steps and obtains transcutaneous laser myocardial blood transport reconstruction process Position, quantity, depth, aperture and the energy in middle laser duct:
Step 1 determines the ischemic range of cardiac muscular tissue, total blood flow required for assessing.
Operation consent measures blood viscosity η by hemodynamic examination heart left chamber internal pressure Δ p, hemorheology, just Positron emission tomography detects myocardial ischemia range, total blood flow range needed for ischemic myocardium is quantitatively evaluated according to clinical experience [V1 0,V2 0], and the groundwater increment range [V in single laser duct is set according to clinical experiencesmin,Vsmax] and single laser hole Pore diameter range [the d in roadmin,dmax]。
Step 2, the ischemic area of gridding cardiac muscular tissue.
Whether the thickness for enhancing magnetic resonance detection myocardial wall by Three-Dimensional Dynamic is uniform.If it is not, according to myocardial wall Different-thickness is divided into multiple grids using bounded member/FInite Element, is then successively numbered 1,2 to all grids ..., N； Assessment records the thickness range of each net region myocardium wallWherein,For the minimum myocardial wall of j-th of grid Thickness,For the thickness of the maximum myocardial wall of j-th of grid, j=1,2 ..., N.Determine the minimum thickness of ischemic myocardium wallMaximum gaugeWhen myocardium thickness distribution is uniform, Regard grid number as 1.
When grid dividing, non-unified Rational B-splines (NURBS) surface fitting is carried out to ischemic myocardium, uses mapping mode Grid dividing is carried out to structural model, the network of mixed type is selected, to big deformation cardiac muscle based on hexahedral element；It does not advise Then regional myocardial is optimized using tetrahedral grid.Cardiac muscular tissue within the scope of certain thickness is divided in the same grid.
Step 3 primarily determines the output power P of laser.
Type selecting is carried out to laser, and under the initial option laser conditions laser output power P.
The laser that laser myocardial revascularization is selected should have characteristics that (1) tissue penetration depths are big, vaporize Myocardium accuracy is high, and the thermocoagulation necrotic extent caused by surrounding myocardium is small；(2) biological tissue's genetic mutation is not easily leaded to； (3) it can be transmitted using optical fiber, be combined with scope and carry out body intracavity operation.Laser type ideal at present is quasi- point The laser of subclass, such as carbon dioxide laser, Nd:YAG laser, Ho:YAG laser etc..Carbon dioxide laser is gas laser, cannot It is transmitted through optical fiber；Since Ho:YAG laser can be transmitted by low hydrogen oxonium ion silica fibre, so Ho:YAG laser percutaneously swashs The zoopery and clinical test of light myocardial revascularization have obtained widely carrying out.
For j-th of grid, when the output power density of laser is greater than formulaIdentified power is close When spending, process of the process of laser vaporization cardiac muscle just based on the thermal conductivity is changed into the process based on the latent heat of vaporization.At this moment laser Cardiac muscular tissue can be vaporized more accurately, and reduces the damage to surrounding myocardium.Wherein, Pc,iFor i-th laser duct Laser power density, q are the heat of vaporization of cardiac muscular tissue, and ρ is the density of cardiac muscular tissue, tiIt is raw for the duct in i-th of laser duct At the time, k is thermal diffusivity.
It selectes laser duct position: being directed to each grid, it is first determined the position in first laser duct is grid Myocardial wall thickest part, the spacing between laser duct are 1cm, and myocardial wall corresponding to the position in laser duct is in the ultrasonic heart Cardon checks that the thickness of diastole need to be greater than or equal to 8mm, realizes that laser duct is uniformly distributed.
Step 4: determine that duct generates the time
Because vaporization takes place in laser action from Laser emission to cardiac muscular tissue, during which the time experienced is t0.People's Main component is hydrone, and when temperature reaches 100 DEG C, water is vaporized, and the body temperature of human normal is 37 DEG C, it is assumed that myocardium group It is equal with normal body temperature to knit temperature, so t0It can be expressed as
Wherein, K is the pyroconductivity of cardiac muscular tissue；T=T (x, y, z, t) is the raised space-time of cardiac muscular tissue's internal temperature Distribution function, in cardiac muscular tissue, T=100-37；I0For the laser intensity for being incident on myocardial tissue surface.
When it is fixed value P that step 3, which has selected laser output power, for the cardiac muscle of j-th of grid, it is first determined the net The position in first laser duct of lattice is that the most thick position of myocardial wall (can be during grid dividing, so that in the grid most Thick myocardial wall is located at grid element center), then determine other laser duct positions be centered on first laser duct successively between Every 1cm (can along in grid dividing x-axis and y-axis determine other laser duct positions).According to myocardium at the position of laser duct The relevant parameter (maximum of i.e. i-th grid, minimum myocardial wall thickness) of tissue, as long as laser duct depth required for providing zi, so that it may determine that duct actually required with this condition generates time ti.Wherein, ziIt is the depth in i-th of laser duct. HminMinimum myocardial wall thickness where the laser duct in grid, also, remain myocardial wall wall thickness after the generation of laser duct and answer More than or equal to 4mm.
Wherein, q is the heat of vaporization of cardiac muscular tissue, and c is the specific heat of cardiac muscular tissue, and ρ is the density of cardiac muscular tissue, ω0For zi= The waist radius of the Gaussian beam of (the myocardium wall surface i.e. where the laser duct), is constant at 0, and λ is optical maser wavelength.
Step 5, the comparison for the laser output power that threshold power is set with step 3
Formula is selected according to the threshold power of the laser on unit areaBy myocardium group The various parameters knitted: latent heat of vaporization q=2257J/g, density p=1.2g/cm3, thermal diffusivity k=1.400x10-3cm2/ s, heat DiffusivityAnd the duct that step 4 determines generates time tiIt substitutes into formula, obtains threshold power Pc,i, by threshold value function Rate Pc,iIt is compared with the laser output power P of step 3 setting, if P < Pc,i, then reset laser output power and Duct generates the time, and setting method is as follows: laser is constant, tunes up the output power of laser, recalculates duct and generates the time, Then compare Pc,iAnd P, until P >=Pc,i；Otherwise switch to step 6.
Step 6 determines laser aperture.
The laser output power P that step 5 is finally determined and duct generate time tiIt substitutes into following formula and determines laser duct Aperture di:
Wherein, ziFor the depth in i-th of laser duct, μaIt is cardiac muscular tissue to the absorption coefficient of laser, ω is Gaussian beam The waist radius of any depth in cardiac muscle, is variable.
If di∈[dmin,dmax], then step 7 is executed, otherwise increases the depth in laser duct, recalculate duct generation Time and threshold power Pc,i, and by threshold power Pc,iCompare with laser output power P, until P >=Pc,iAnd di∈[dmin, dmax].If the depth in laser duct has reached the maximum value (i.e. residual myocardium wall thickness is 4mm), maximum laser duct Depth is the depth in final laser duct.
Step 7, clear i-th of laser duct groundwater increment Vi。
The aperture d in i-th of laser ducti, duct depth zi, left indoor pressure Δ p and hemorheology measurement blood it is viscous It spends the parameters such as η and substitutes into formulaCalculate the blood flow V in the laser ducti；If Vi∈[Vsmin,Vsmax] then above-mentioned The position in the laser duct finally determined, laser output power P, hole depth ziWith aperture diEffectively, otherwise step 3 is returned to again Laser output power is chosen, and then recalculates duct and generates time, duct depth, laser aperture, redefines laser duct Groundwater increment.
Step 8: the related data of this punch operation is exported
The accumulation groundwater increment in i laser duct before calculatingPrint data (i, P, P are exported simultaneouslyc,i,ti, hi,di,Vi,Vi,sum)。
Step 9: the parameter in next laser duct is determined
By the accumulation groundwater increment V in preceding i laser ducti,sumWith the maximum value of total blood flow needed for ischemic myocardiumIt carries out Compare, ifThen calculate remaining minimum filling amountRemaining maximum groundwater increment Remaining laser duct number minimum reference valueRemaining laser duct number maximum reference valueAnd print number According toThen it determines next laser duct parameter, determines next laser hole marked as i+1 Road position, repeats the above process.Wherein, the position in next laser duct are as follows: with present laser duct interval 1cm, along up time It is unfolded to arrange laser hole road in whole ischemic myocardiums until all grids in needle direction.WhenOutputCalculating process terminates.
In conclusion the above is merely preferred embodiments of the present invention, being not intended to limit the scope of the present invention. All within the spirits and principles of the present invention, any modification, equivalent replacement, improvement and so on should be included in of the invention Within protection scope.

Claims (4)

1. a kind of clinical intelligent transcutaneous laser myocardial blood transport reconstruction laser duct parameter calculation apparatus, which is characterized in that based on Position, quantity, depth, aperture and the energy in laser duct during calculation transcutaneous laser myocardial blood transport reconstruction；Described device packet Include processing module, the processing module is according to the thickness of myocardial wall, using bounded member or FInite Element to identified myocardium group The ischemic area knitted carries out grid dividing, the cardiac muscular tissue within the scope of certain thickness is divided in the same grid, and to institute There is grid to be numbered；Record the thickness range of each net region myocardium wall；
The processing module determines laser duct position: being directed to each grid, it is first determined the position in first laser duct For grid element center flesh wall thickest part, the spacing between laser duct is 1cm；Wherein, the heart corresponding to the position in laser duct Thickness of the flesh wall in echocardiography diastole cannot be less than 8mm；Primarily determine the output power P of laser；
The processing module is directed to present laser duct i, determines that the duct in present laser duct generates time t according to formula (1)i,
Wherein, P is the output power of laser；t0To be passed through from Laser emission to cardiac muscular tissue because vaporization takes place in laser action The time gone through；ρ is the density of cardiac muscular tissue；Q is the heat of vaporization of cardiac muscular tissue；C is the specific heat of cardiac muscular tissue；λ is optical maser wavelength； ziFor the depth in i-th of laser duct, wherein the residual myocardium wall thickness in laser duct is greater than or equal to 4mm；ω0For zi=0 The waist radius of the Gaussian beam at place；
The processing module generates time t using determining ducti, the threshold power P of laser is calculated using formula (2)c,i；
Wherein, k is thermal diffusivity；
The threshold power P obtained will be calculatedc,iIt is compared with laser output power P, if P < Pc,i, then the output of laser is tuned up Power recalculates duct and generates the time, until P >=Pc,i；
The processing module generates time t according to finally determining laser output power P and ducti, worked as using formula (3) determination The aperture d in preceding laser ducti；
Wherein, μaIt is cardiac muscular tissue to the absorption coefficient of laser；ω is the waist radius of Gaussian beam any depth in cardiac muscle；
If diIn the pore diameter range of setting, then processing module determines the groundwater increment in present laser duct according to formula (4) Vi, after otherwise increasing the depth in laser duct, recalculate duct and generate time and threshold power Pc,i, until P >=Pc,iAnd diPosition In in the pore diameter range of setting；If the depth in laser duct has reached the maximum value, i.e. residual myocardium wall thickness is 4mm, then Maximum laser duct depth is the depth in final laser duct；
Wherein,
Wherein, Δ p is left indoor pressure, and η is blood viscosity；
If ViWithin the scope of the groundwater increment in the single laser duct of setting, then the above-mentioned laser duct position finally determined, laser are defeated Power P, hole depth z outiWith aperture diThe as parameter in i-th of laser duct；Otherwise, after choosing laser output power P again, Redefine the parameter in i-th of laser duct；
The processing module is by the accumulation groundwater increment V in preceding i laser ducti,sumWith total blood flow needed for identified ischemic myocardium Maximum valueIt is compared, ifThen determine the parameter in next laser duct, wherein next laser hole The position in road are as follows: with present laser duct interval 1cm；IfThen terminate the calculating of laser duct parameter.
2. clinical intelligent transcutaneous laser myocardial blood transport reconstruction laser duct parameter calculation apparatus as described in claim 1, special Sign is that in grid dividing, each grid element center is arranged in the net region at maximum myocardial wall thickness the processing module.
3. clinical intelligent transcutaneous laser myocardial blood transport reconstruction laser duct parameter calculation apparatus as claimed in claim 1 or 2, It being characterized in that, the processing module carries out non-unified rational B-spline surface fitting to ischemic myocardium first in grid dividing, Then grid dividing is carried out to structural model using mapping mode, the network of mixed type is selected, to big deformation cardiac muscle with six Based on the body unit of face；Irregular area cardiac muscle is optimized using tetrahedral grid, finally by the cardiac muscular tissue within the scope of certain thickness It is divided in the same grid.
4. clinical intelligent transcutaneous laser myocardial blood transport reconstruction laser duct parameter calculation apparatus as described in claim 1, special Sign is that the processing module determines next laser hole when determining the position in next laser duct along clockwise direction The position in road, until there is laser duct on the ischemic myocardium in all grids.
CN201610178512.6A 2016-03-25 2016-03-25 Clinical intelligence transcutaneous laser myocardial blood transport reconstruction laser duct parameter calculation apparatus Active CN105708545B (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
CN201610178512.6A CN105708545B (en) 2016-03-25 2016-03-25 Clinical intelligence transcutaneous laser myocardial blood transport reconstruction laser duct parameter calculation apparatus

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
CN201610178512.6A CN105708545B (en) 2016-03-25 2016-03-25 Clinical intelligence transcutaneous laser myocardial blood transport reconstruction laser duct parameter calculation apparatus

Publications (2)

Publication Number Publication Date
CN105708545A CN105708545A (en) 2016-06-29
CN105708545B true CN105708545B (en) 2019-01-01

Family

ID=56158284

Family Applications (1)

Application Number Title Priority Date Filing Date
CN201610178512.6A Active CN105708545B (en) 2016-03-25 2016-03-25 Clinical intelligence transcutaneous laser myocardial blood transport reconstruction laser duct parameter calculation apparatus

Country Status (1)

Country Link
CN (1) CN105708545B (en)

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5389096A (en) * 1990-12-18 1995-02-14 Advanced Cardiovascular Systems System and method for percutaneous myocardial revascularization
WO1997029803A1 (en) * 1996-02-20 1997-08-21 Cormedica Percutaneous endomyocardial revascularization

Family Cites Families (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5931834A (en) * 1996-10-15 1999-08-03 Eclipse Surgical Technologies, Inc. Method for non-synchronous laser-assisted myocardial revascularization
US20010014857A1 (en) * 1998-08-14 2001-08-16 Zifei Peter Wang A voice activity detector for packet voice network

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5389096A (en) * 1990-12-18 1995-02-14 Advanced Cardiovascular Systems System and method for percutaneous myocardial revascularization
WO1997029803A1 (en) * 1996-02-20 1997-08-21 Cormedica Percutaneous endomyocardial revascularization

Non-Patent Citations (4)

* Cited by examiner, † Cited by third party
Title
激光心肌血管重建术的应用基础研究;唐震;《中国优秀硕士学位论文全文数据库医药卫生科技辑》;20060430;全文
红外激光心肌打孔热损伤的计算研究;罗乐;《应用激光》;20080430;第28卷(第2期);全文
红外激光心肌打孔的理论模型和实验验证;罗乐;《光子学报》;20050630;第34卷(第6期);全文
经皮激光心肌血运重建术治疗心肌缺血机制的实验研究;卢才义;《中华医学杂志》;20031210;第83卷(第23期);全文

Also Published As

Publication number Publication date
CN105708545A (en) 2016-06-29

Similar Documents

Publication Publication Date Title
US20210338484A1 (en) Systems and methods for ocular laser surgery and therapeutic treatments
US7871406B2 (en) Methods for planning and performing thermal ablation
US7699778B2 (en) Ultrasound cardiac stimulator
US8155416B2 (en) Methods and apparatuses for planning, performing, monitoring and assessing thermal ablation
CN105148416B (en) Medical system including percutaneous electrode
JP2020512917A5 (en)
WO2021208306A1 (en) System for predicting electrical pulse ablation area
US20080033417A1 (en) Apparatus for planning and performing thermal ablation
US20080033419A1 (en) Method for planning, performing and monitoring thermal ablation
CN105999569B (en) A kind of array element selection device of more element transducers, method and ultrasound stimulation system
RU2011149451A (en) TREATMENT OF Atrial fibrillation with atrial fibrillation using high-frequency electrostimulation and ablation of renal nerves
CN103054553B (en) Microcirculatory method of real-time, system and detecting head in a kind of point skin tissue
WO2014121292A1 (en) Catheter-based ultrasound transducers
CN111870344B (en) Preoperative navigation method, system and terminal equipment
Getman et al. Relationship between time‐to‐isolation and freeze duration: Computational modeling of dosing for Arctic Front Advance and Arctic Front Advance Pro cryoballoons
KR101221824B1 (en) Apparatus for Treatment and Driving Method Thereof
Wongchadakul et al. Mathematical Modeling of Multilayered Skin with Embedded Tumor Through Combining Laser Ablation and Nanoparticles: Effects of Laser Beam Area, Wavelength, Intensity, Tumor Absorption Coefficient and Its Position.
CN105708545B (en) Clinical intelligence transcutaneous laser myocardial blood transport reconstruction laser duct parameter calculation apparatus
Trayanova Your personal virtual heart
CN116271563A (en) Semiconductor laser therapeutic apparatus control method and system
CN109223175A (en) A kind of three-dimensional based endoscopic imaging laser therapeutic system
Stephens et al. Multifunctional catheters combining intracardiac ultrasound imaging and electrophysiology sensing
Saccomandi et al. Theoretical assessment of principal factors influencing laser interstitial thermotherapy outcomes on pancreas
KR20070016073A (en) Simulation of Invasive Procedures
KR101432368B1 (en) System and method for generating pseudo electrogram

Legal Events

Date Code Title Description
C06 Publication
PB01 Publication
C10 Entry into substantive examination
SE01 Entry into force of request for substantive examination
GR01 Patent grant
GR01 Patent grant