CN116172615B - Method and device for acquiring heart obstruction coefficient based on 4D-CTA and CFD - Google Patents
Method and device for acquiring heart obstruction coefficient based on 4D-CTA and CFD Download PDFInfo
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Abstract
The application relates to a method and a device for acquiring heart obstruction coefficients based on 4D-CTA and CFD, and relates to the technical field of medical treatment. The method for acquiring the heart obstruction coefficient based on the 4D-CTA and the CFD comprises the following steps: acquiring a 4D-CTA image, and generating a local blood flow cavity three-dimensional model according to the 4D-CTA image; performing CFD simulation analysis on the three-dimensional model of the local blood flow cavity to generate a simulation analysis result; obtaining the pressure drop from the left chamber to the ascending aorta section corresponding to the cardiac output according to the simulation analysis result; based on cardiac output and left ventricular chamber to ascending aortic segment pressure drop, a heart obstruction factor is obtained, wherein the heart obstruction factor is used to assess the severity of left ventricular outflow obstruction and aortic valve stenosis. The application is used for solving the problems that the acquisition of the parameter value for evaluating left ventricular outflow obstruction and aortic valve stenosis is difficult or the parameter value is inaccurate.
Description
Technical Field
The application relates to the technical field of medical treatment, in particular to a method and a device for acquiring heart obstruction coefficients based on 4D-CTA and CFD.
Background
Left ventricular outflow obstruction refers generally to the condition where the blood flow of a patient with hypertrophic obstructive heart disease is blocked by the SAM (systolicanterior motion ) of the hypertrophic ventricular septum myocardium and mitral valve during systole ejection phase, and the heart cannot be effectively pumped out. Aortic stenosis can also create an obstruction to the heart jet. When the left ventricle of the human body flows out to cause obstruction, symptoms such as fatigue, dyspnea, exercise intolerance, palpitation, syncope and the like can be generated, and the heart sudden death can be caused most seriously.
The current clinical approach for quantitatively describing left ventricular outflow obstruction and aortic valve stenosis is mainly the differential pressure calculated based on the maximum flow rate of color Doppler ultrasound measurements. In addition, the pressure difference between the left chamber and the aortic segment is measured by using the catheter to judge the obstruction of the patient.
Color Doppler ultrasound technology is widely applied, but can generate obvious fluctuation when being clinically applied to evaluating left ventricular outflow obstruction and aortic valve stenosis, and sometimes the measurement result has certain difference with the image information of a patient and the actual clinical manifestation. From the viewpoint of hydrodynamics, the differential pressure calculation formula is based on the Bernoulli equation under ideal condition, the derivation process is simplified to a certain extent, on the other hand, the ultrasonic beam inevitably has a certain angle with the direction of blood flow measurement, which may cause certain errors for clinical diagnosis of patients with left ventricular outflow obstruction and aortic valve stenosis. In addition, the method for measuring the pressure difference by using the catheter is less in clinical application than the color Doppler ultrasonic technology due to the originality and cost.
In summary, the current parameter values used to assess left ventricular outflow obstruction and aortic valve stenosis are difficult to obtain or are not sufficiently accurate.
Disclosure of Invention
The application provides a method and a device for acquiring heart obstruction coefficients based on 4D-CTA and CFD, which are used for solving the problems that the acquisition of parameter values for evaluating left ventricular outflow obstruction and aortic valve stenosis is difficult or the parameter values are inaccurate.
In a first aspect, an embodiment of the present application provides a method for obtaining a cardiac obstruction factor based on 4D-CTA and CFD, including:
acquiring a 4D-CTA image, and generating a local blood flow cavity three-dimensional model according to the 4D-CTA image;
performing CFD simulation analysis on the local blood flow cavity three-dimensional model to generate a simulation analysis result;
obtaining the pressure drop from the left chamber to the ascending aorta section corresponding to the cardiac output according to the simulation analysis result;
and obtaining a heart obstruction coefficient according to the cardiac output and the pressure drop from the left chamber cavity to the ascending aortic segment, wherein the heart obstruction coefficient is used for evaluating the severity of left chamber outflow obstruction and aortic valve stenosis.
Optionally, performing CFD simulation analysis on the three-dimensional model of the local blood flow cavity to generate a simulation analysis result, including:
obtaining N cardiac output, wherein N is an integer greater than 1, the N cardiac output is a set value, and the N cardiac output are different;
and performing CFD simulation analysis on the three-dimensional model of the local blood flow cavity according to the N cardiac output quantities to generate simulation analysis results.
Optionally, the obtaining, according to the simulation analysis result, a pressure drop from the left chamber to the ascending aortic segment corresponding to the cardiac output includes:
according to the simulation analysis result, obtaining the left chamber pressure corresponding to the cardiac output and the ascending aorta pressure corresponding to the cardiac output;
and subtracting the ascending aorta pressure corresponding to the cardiac output from the left chamber pressure corresponding to the cardiac output to obtain the pressure drop from the left chamber to the ascending aorta segment corresponding to the cardiac output.
Optionally, the obtaining, according to the simulation analysis result, the left ventricular cavity pressure corresponding to the cardiac output and the ascending aorta pressure corresponding to the cardiac output includes:
according to the simulation analysis result, M first pressure values corresponding to the cardiac output in the left chamber area are obtained, wherein M is an integer greater than 1;
calculating an average value of the M first pressure values, and taking the average value of the M first pressure values as the left chamber pressure corresponding to the cardiac output;
according to the simulation analysis result, M second pressure values corresponding to the cardiac output in the ascending aorta area are obtained;
and calculating the average value of the M second pressure values, and taking the average value of the M second pressure values as the ascending aorta pressure corresponding to the cardiac output.
Optionally, the obtaining the heart obstruction factor according to the cardiac output and the pressure drop from the left chamber to the ascending aortic segment comprises:
calculating a square value of the cardiac output;
dividing the pressure drop from the left chamber to the ascending aortic segment by the square value to obtain the heart obstruction coefficient.
In a second aspect, an embodiment of the present application provides a device for acquiring a heart obstruction factor based on 4D-CTA and CFD, including:
the first generation module is used for acquiring a 4D-CTA image and generating a local blood flow cavity three-dimensional model according to the 4D-CTA image;
the second generation module is used for carrying out CFD simulation analysis on the local blood flow cavity three-dimensional model and generating a simulation analysis result;
the acquisition module is used for acquiring the pressure drop from the left chamber to the ascending aorta section corresponding to the cardiac output according to the simulation analysis result;
and the processing module is used for obtaining a heart obstruction coefficient according to the cardiac output and the pressure drop from the left chamber cavity to the ascending aortic segment, wherein the heart obstruction coefficient is used for evaluating the severity degree of left chamber outflow obstruction and aortic valve stenosis.
Optionally, the second generating module includes:
the first acquisition submodule is used for acquiring N cardiac output, wherein N is an integer greater than 1, the N cardiac output is a set value, and the N cardiac output is different;
and the first processing submodule is used for carrying out CFD simulation analysis on the three-dimensional model of the local blood flow cavity according to the N cardiac output quantities to generate a simulation analysis result.
Optionally, the acquiring module includes:
the second acquisition submodule is used for acquiring the left ventricular cavity pressure corresponding to the cardiac output and the ascending aorta pressure corresponding to the cardiac output according to the simulation analysis result;
and the second processing sub-module is used for subtracting the ascending aorta pressure corresponding to the cardiac output from the left chamber pressure corresponding to the cardiac output to obtain the pressure drop from the left chamber corresponding to the cardiac output to the ascending aorta segment.
Optionally, the second obtaining sub-module includes:
the first acquisition unit is used for acquiring M first pressure values corresponding to the cardiac output in the left chamber area according to the simulation analysis result, wherein M is an integer greater than 1;
a first processing unit, configured to calculate an average value of the M first pressure values, and use the average value of the M first pressure values as a left chamber pressure corresponding to the cardiac output;
the second acquisition unit is used for acquiring M second pressure values corresponding to the cardiac output in the ascending aorta region according to the simulation analysis result;
and the second processing unit is used for calculating the average value of the M second pressure values and taking the average value of the M second pressure values as the ascending aorta pressure corresponding to the cardiac output.
Optionally, the processing module includes:
a third processing sub-module for calculating a square value of the cardiac output;
and a fourth processing submodule, configured to divide the pressure drop from the left chamber to the ascending aortic segment by the square value to obtain a heart obstruction coefficient.
Compared with the prior art, the technical scheme provided by the embodiment of the application has the following advantages: in the embodiment of the application, a 4D-CTA image is acquired, a local blood flow cavity three-dimensional model is generated according to the 4D-CTA image, CFD simulation analysis is carried out on the local blood flow cavity three-dimensional model, a simulation analysis result is generated, the pressure drop from the left chamber corresponding to cardiac output to the ascending aortic segment is obtained according to the simulation analysis result, and the heart obstruction coefficient is obtained according to the cardiac output and the pressure drop from the left chamber to the ascending aortic segment, wherein the heart obstruction coefficient is used for evaluating the severity of left chamber outflow obstruction and aortic valve stenosis. According to the application, based on 4D-CTA image and CFD simulation analysis, simulation analysis results are generated, compared with the prior art that the differential pressure is measured by using a catheter, the differential pressure measuring device is noninvasive, has low cost, can more conveniently acquire the pressure drop from the left chamber corresponding to cardiac output to the ascending aortic segment, further acquires the heart obstruction coefficient to evaluate the severity of left chamber outflow obstruction and aortic valve stenosis, and solves the problem that the parameter values for evaluating the left chamber outflow obstruction and aortic valve stenosis are difficult to acquire at present. In addition, based on 4D-CTA image and CFD simulation analysis, a simulation analysis result is generated, the pressure drop from the left chamber corresponding to the cardiac output to the ascending aortic segment is obtained according to the simulation analysis result, compared with the pressure difference calculated based on the maximum flow rate measured by color Doppler ultrasound in the prior art, the pressure drop from the left chamber corresponding to the cardiac output to the ascending aortic segment is directly obtained according to the simulation analysis result, the error caused by the simplification of a pressure difference calculation formula is avoided, the error caused by a certain angle between an ultrasonic beam and the measurement blood flow direction is avoided, the obtained pressure drop from the left chamber to the ascending aortic segment is more accurate, the obtained heart obstruction coefficient is more accurate, the severity of left-chamber outflow obstruction and aortic valve stenosis can be estimated more accurately, and the problem that the parameter values for estimating the left-chamber outflow obstruction and the aortic valve stenosis are inaccurate at present is solved.
Drawings
The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate embodiments consistent with the application and together with the description, serve to explain the principles of the application.
In order to more clearly illustrate the embodiments of the application or the technical solutions of the prior art, the drawings which are used in the description of the embodiments or the prior art will be briefly described, and it will be obvious to a person skilled in the art that other drawings can be obtained from these drawings without inventive effort.
FIG. 1 is a flow chart of a method for obtaining heart obstruction coefficients based on 4D-CTA and CFD in an embodiment of the application;
FIG. 2 is a schematic view of a three-dimensional model of a local blood flow lumen from the left ventricular chamber to the aortic segment of a febrile disease patient in accordance with one embodiment of the present application;
FIG. 3 is a simplified illustration of hemodynamic mapping based on a three-dimensional model of a local blood flow lumen, in accordance with an embodiment of the present application;
FIG. 4 is a schematic representation of a three-dimensional model of a local blood flow lumen at the end systole of a pre-and post-operative hypertrophic obstructive heart disease patient generated from 4D-CTA images in accordance with one embodiment of the present application;
FIG. 5 is a graph showing the pressure drop from the left chamber to the ascending aortic segment at different cardiac output according to the results of the simulation analysis of cases a, b, and c in an embodiment of the present application;
FIG. 6 is a graph showing the pressure drop from the left chamber to the ascending aortic segment at different cardiac output according to the results of the simulation analysis of cases d, e, f in an embodiment of the present application;
FIG. 7 is a graph showing the results of calculation of the heart obstruction factor at different cardiac output based on the results of the simulation analysis of case a, b, c, d, e, f in an embodiment of the present application;
FIG. 8 is a schematic diagram of a device for acquiring heart obstruction coefficients based on 4D-CTA and CFD according to an embodiment of the present application.
Detailed Description
For the purpose of making the objects, technical solutions and advantages of the embodiments of the present application more apparent, the technical solutions of the embodiments of the present application will be clearly and completely described below with reference to the accompanying drawings in the embodiments of the present application, and it is apparent that the described embodiments are some embodiments of the present application, but not all embodiments of the present application. All other embodiments, which can be made by those skilled in the art based on the embodiments of the application without making any inventive effort, are intended to be within the scope of the application.
The embodiment of the application provides a heart obstruction coefficient acquisition method based on 4D-CTA and CFD. As shown in fig. 1, the method flow for obtaining the heart obstruction coefficient based on 4D-CTA and CFD mainly comprises:
step 101, acquiring a 4D-CTA image, and generating a local blood flow cavity three-dimensional model according to the 4D-CTA image.
Wherein, 4D-CTA (4-dimensions-computedtomography angiography, four-dimensional computer body layer blood vessel imaging) is a dynamic CTA technology, and the time dimension parameter is added on the basis of CTA.
In one embodiment, as shown in FIG. 2, a three-dimensional model of the left ventricular chamber to aortic segment local blood flow chamber of a febrile patient is shown. In one embodiment, as shown in FIG. 3, a simplified hemodynamic diagram is depicted based on a three-dimensional model of a local blood flow lumen. The specific meaning of each parameter in fig. 2 and 3 is as follows:-systolic blood flow,/->-ascending aortic pressure,>-outflow tract pressure, < >>-left chamber pressure,/->-ascending aortic blood flow velocity,/->-outflow tract blood flow velocity, < >>-left ventricular cavity blood flow velocity,/->Left chamber to outflow tract Duan Yacha, -a left chamber to outflow tract>Left ventricular chamber to ascending aortic segment pressure drop,AVthe aortic valve is of the type in question,MV-mitral valve.
In one embodiment, as shown in FIG. 4, a three-dimensional model of the end systole of a pre-and post-operative hypertrophic obstructive heart disease patient is shown, generated from a 4D-CTA image. A three-dimensional model of the local blood flow lumen of six patients before and after surgery is shown in fig. 4. The surgical procedures performed by the patient of case number a were cardiomyotomy and mitral valve annuloplasty, the surgical procedures performed by the patient of case number b were cardiomyotomy and mitral valve annuloplasty, the surgical procedures performed by the patient of case number c were cardiomyotomy and mitral valve annuloplasty, the surgical procedures performed by the patient of case number d were cardiomyotomy, mitral valve annuloplasty, and the surgical procedures performed by the patient of case number e were cardiomyotomy and mitral valve annuloplasty, and the surgical procedures performed by the patient of case number f were cardiomyotomy and mitral valve replacement. From fig. 4, it can be seen that six pre-operative patients exhibited varying degrees of outflow obstruction, which was correspondingly eliminated.
And 102, performing CFD simulation analysis on the three-dimensional model of the local blood flow cavity to generate a simulation analysis result.
To quantitatively evaluate the severity of the obstruction in each case, as well as the improvement of the postoperative obstruction, relevant parameters were obtained by CFD (ComputationalFluid Dynamics ) simulation analysis of a three-dimensional model of the local blood flow lumen. Wherein, the pressure boundary condition refers to the clinical measurement of blood pressure of a patient, and the flow boundary condition is set to 3L/min. The simulation analysis results comprise the calculation domain, the pressure distribution, the blood flow velocity distribution and the wall shear stress distribution before and after operation. According to the simulation analysis result, the most serious position of the outflow obstruction of the preoperative patient can be intuitively observed, the situation that the obvious blood flow speed is increased locally is relatively consistent with the color Doppler ultrasonic measurement result, and the abnormal pressure drop and the situation that the wall shear stress of the narrow part is increased locally are generated, so that the method is favorable for determining the main pathological change area of the obstruction and positioning the myocardial resection position of the operation. The distribution of local hemodynamic parameters is also restored to normal as the outflow obstruction is eliminated after the operation.
In one embodiment, performing CFD simulation analysis on a three-dimensional model of a local blood flow chamber to generate a simulation analysis result, including: obtaining N cardiac output quantities, wherein N is an integer greater than 1, the N cardiac output quantities are set values, and the N cardiac output quantities are different; and carrying out CFD simulation analysis on the three-dimensional model of the local blood flow cavity according to the N cardiac output quantities to generate a simulation analysis result.
Due to abnormal blood flow velocity at the obstruction, the acquisition of cardiac output is often difficult for patients with outflow obstruction or aortic valve stenosis. In the application, the setting of the cardiac output can be conveniently adjusted in CFD simulation analysis, the problem of difficult acquisition of the cardiac output is solved, and the cardiac output value of the patient is more accurate because the cardiac output of the patient is obtained by setting.
And step 103, obtaining the pressure drop from the left chamber to the ascending aorta section corresponding to the cardiac output according to the simulation analysis result.
In a specific embodiment, according to the simulation analysis result, obtaining the pressure drop from the left chamber to the ascending aorta segment corresponding to the cardiac output includes: according to the simulation analysis result, obtaining left chamber pressure corresponding to cardiac output and ascending aorta pressure corresponding to cardiac output; and subtracting the ascending aorta pressure corresponding to the cardiac output from the left chamber pressure corresponding to the cardiac output to obtain the pressure drop from the left chamber corresponding to the cardiac output to the ascending aorta segment.
In the simulation analysis result, the pressure in the left chamber area and the pressure in the ascending aorta area are counted to obtain the pressure difference between the two areas, namely the pressure drop from the left chamber to the ascending aorta section.
In a specific embodiment, according to the simulation analysis result, obtaining the left ventricular chamber pressure corresponding to the cardiac output and the ascending aorta pressure corresponding to the cardiac output includes: according to simulation analysis results, M first pressure values corresponding to cardiac output in the left chamber area are obtained, wherein M is an integer greater than 1; calculating the average value of the M first pressure values, and taking the average value of the M first pressure values as the left chamber pressure corresponding to cardiac output; obtaining M second pressure values corresponding to the cardiac output in the ascending aorta region according to the simulation analysis result; and calculating the average value of the M second pressure values, and taking the average value of the M second pressure values as the ascending aorta pressure corresponding to the cardiac output.
Wherein M is a preset value. For example, M is 10. Considering that the pressure values of different points in the same area have certain difference, calculating the average value of M points in the area to represent the pressure value of the area, so that the calculated pressure value can represent the pressure value of the area more.
In one embodiment, as shown in fig. 5, a schematic diagram of the pressure drop from the left chamber to the ascending aortic segment at different cardiac output is plotted according to the results of the simulation analysis of cases a, b, and c. In fig. 5, a1 represents a case a before operation, a2 represents a case a after operation, b1 represents a case b before operation, b2 represents a case b after operation, c1 represents a case c before operation, and c2 represents a case c after operation. In one embodiment, as shown in FIG. 6, a schematic diagram of the left ventricular chamber to ascending aortic segment pressure drop at different cardiac output is plotted according to the results of the simulation analysis of cases d, e, f. In fig. 6, d1 represents before the case d operation, d2 represents after the case d operation, e1 represents before the case e operation, e2 represents after the case e operation, f1 represents before the case f operation, and f2 represents after the case f operation. In fig. 5 and 6, the abscissa represents cardiac output CO in L/min, and the ordinate represents the left ventricular chamber to ascending aortic segment pressure drop PD in mmHg. As the setting of cardiac output can be conveniently adjusted in CFD simulation analysis, eight different cardiac outputs of 3.0, 3.6, 4.2, 4.8, 5.4, 6.0, 6.6 and 7.2L/min are respectively set and calculated for the same three-dimensional model of the local blood flow cavity, and then the pressure drop from the left chamber cavity to the ascending aortic segment is counted.
As can be seen from fig. 5 and 6, for six patients, the preoperative left ventricular chamber to ascending aortic segment pressure drop was significantly higher than the postoperative left ventricular chamber to ascending aortic segment pressure drop, which can be used as a basis for clinical evaluation of the severity of obstruction, as well as the effectiveness of the post-operative patient treatment of obstruction. It can also be seen from figures 5 and 6 that the pressure drop from the left chamber of the patient to the ascending aortic segment also varies significantly with the cardiac output.
Step 104, obtaining the heart obstruction coefficient according to the cardiac output and the pressure drop from the left chamber to the ascending aortic segment.
The heart obstruction factor is used to assess the severity of left ventricular outflow obstruction and aortic valve stenosis, among other things.
The application relates to a parameter which is derived by basic theory and formula based on the hydrodynamic field and is called heart obstruction coefficient. The heart obstruction factor is mainly determined by the blood flow cavity morphology of the patient, and is not disturbed by other factors, so that the severity of left ventricular outflow obstruction and aortic valve stenosis can be more accurately estimated. However, the heart obstruction factor requires clinical acquisition of the pressure drop from the left ventricular chamber to the ascending aortic segment of the patient and cardiac output. Due to abnormal blood flow velocity at the obstruction, it is often difficult to obtain cardiac output in patients with outflow obstruction or aortic valve stenosis. And the current method of measuring pressure from the left chamber to the ascending aortic segment is needed, so that the cost is relatively high and the method is not suitable for all patients, and the clinical application of the heart obstruction coefficient can be restricted. In order to more conveniently and accurately acquire the heart obstruction coefficient, the acquisition of relevant parameters is realized through 4D-CTA and CFD simulation technology.
In one embodiment, obtaining the heart obstruction factor from cardiac output and left ventricular chamber to ascending aortic segment pressure drop comprises: calculating a square value of cardiac output; the left ventricular chamber to ascending aortic segment pressure drop was divided by the square to obtain the heart obstruction factor.
The specific derivation process for calculating the heart obstruction coefficient is as follows:
based on the bernoulli equation for the actual fluid, one can get:
（1）
wherein, the liquid crystal display device comprises a liquid crystal display device,represents the pressure loss (also known as head loss in fluid mechanics engineering) of the blood flow as it flows through the left chamber to the ascending aortic segment>-blood density->-gravitational acceleration, < >>-left ventricular cavity blood flow velocity,/->-left chamber height,/v>-left chamber pressure,/->-ascending aortic blood flow velocity,/->-ascending aortic height,/->-ascending aortic pressure. Considering that the blood flow velocity of the left ventricular chamber section is closer to the blood flow velocity of the ascending aortic section, assume +.>And without considering the influence of gravitational acceleration, equation (1) can be simplified as:
（2）
wherein, the liquid crystal display device comprises a liquid crystal display device,left ventricular chamber to ascending aortic segment pressure drop. From equation (2), it can be obtained that this segment pressure loss is the main cause of the pressure drop from the left chamber to the ascending aortic segment. Based on hydrodynamics, the pressure loss mainly comprises the along-path pressure loss and the local pressure loss, and the along-path pressure loss is calculated based on the Darcy-Weisbach equation, < >>The calculation formula of (2) is as follows:
（3）
wherein, the liquid crystal display device comprises a liquid crystal display device,-along-the-path pressure loss, < >>-local pressure loss, < >>The Darcy-Weisbach coefficient of friction,left chamber to liter initiativeLength of blood flow lumen of pulse segment->-left ventricular chamber to ascending aortic segment hydraulic diameter, < ->-a local drag coefficient. Equation (3) is mainly used for pressure drop calculation of regular pipes. Since the left ventricular chamber to the ascending aortic segment blood flow chamber tends to be irregularly shaped, equation (3) can also be reduced to:
（4）
wherein, the liquid crystal display device comprises a liquid crystal display device,is the integral resistance coefficient->Is the ascending aortic segment cross-sectional area. Considering that systole often lasts one third of the cardiac cycle we assume systole blood flow +.>Three times the cardiac output CO, i.e. +.>=3co. The combination of equation (4) can be obtained:
（5）
wherein, the liquid crystal display device comprises a liquid crystal display device,namely, the heart obstruction coefficient from the left chamber cavity to the blood flow cavity of the ascending aortic segment can be obtained by combining the formula (2) and the formula (5):
（6）
namely (6)The left ventricular chamber to ascending aortic segment pressure drop was divided by the square to obtain the heart obstruction factor. The heart obstruction factor is theoretically a parameter determined by the morphology of the left chamber to aortic segment blood flow chamber and can be used to quantitatively describe the obstruction at the heart, wherein the properties of blood, including density and viscosity, and the relative roughness of the vessel wall are considered constant. The heart obstruction factor can be calculated directly from two common clinical parameters: left ventricular chamber to ascending aortic segment pressure drop and cardiac output. Considering that the concept of peripheral vascular resistance has been widely accepted clinically, the heart obstruction factor, like it, can be understood as a parameter describing the ease with which a local blood flow lumen delivers blood flow. The value of the heart obstruction factor is between 0 and infinity.Is that blood is regarded as the ideal fluid and the pressure loss can be neglected, i.e。/>Is that the blood flow cavity is completely blocked, and the cardiac output is 0, namely。
According to equation (6), it is necessary to obtain the pressure drop from the left ventricular chamber to the ascending aortic segment and the cardiac output in clinical calculation of the heart obstruction factor, and it is relatively difficult to obtain these two parameters in clinical patients with outflow obstruction and aortic stenosis. The two parameters can be obtained noninvasively and accurately through the 4D-CTA and CFD simulation technology.
In one embodiment, as shown in fig. 7, a schematic diagram of the calculation result of the heart obstruction coefficient under different cardiac output is drawn based on the simulation analysis result of case a, b, c, d, e, f. In fig. 7, the abscissa represents cardiac output CO in L/min and the ordinate represents the heart obstruction coefficient COC. In fig. 7, (a) represents preoperative and (b) represents post-operative. Based on fig. 5, 6 and equation (6), the patient's obstruction factor at different cardiac output can be calculated. As can be seen from fig. 7, the heart obstruction factor calculated based on the simulation analysis result still maintains good stability under different cardiac output and does not change significantly with the change of cardiac output. The six patients before operation have higher heart obstruction coefficients, the obstruction coefficients of the patients after operation are obviously reduced to be below 0.5, and the three-dimensional morphological characteristics are basically consistent with those shown in fig. 4. The results obtained demonstrate that the heart obstruction factor calculated from 4D-CTA based CFD simulation can be effectively applied to assess the severity of outflow tract obstruction.
Compared with the pressure difference from the left chamber to the outflow tract section obtained by measuring the pressure of the clinical catheter and the heart obstruction coefficient obtained by calculating after the cardiac output is measured clinically, the pressure difference from the left chamber to the outflow tract section can be obtained more conveniently and noninvasively based on 4D-CTA and CFD simulation analysis, and the value of the cardiac output is more accurate and the heart obstruction coefficient obtained by calculating based on the pressure difference is more reliable because the cardiac output of a patient is obtained by setting. This facilitates clinically effective use of relevant parameters, providing another reliable means for clinically acquiring the heart obstruction coefficients.
In summary, based on 4D-CTA image and CFD simulation analysis, the simulation analysis result is generated, compared with the prior art that the differential pressure is measured by using a catheter, the method is noninvasive, has low cost, can more conveniently acquire the pressure drop from the left chamber to the ascending aortic segment corresponding to cardiac output, further acquires the heart obstruction coefficient to evaluate the severity of left-chamber outflow obstruction and aortic valve stenosis, and solves the problem that the parameter value for evaluating left-chamber outflow obstruction and aortic valve stenosis is difficult to acquire. In addition, based on 4D-CTA image and CFD simulation analysis, a simulation analysis result is generated, the pressure drop from the left chamber corresponding to the cardiac output to the ascending aortic segment is obtained according to the simulation analysis result, compared with the pressure difference calculated based on the maximum flow rate measured by color Doppler ultrasound in the prior art, the pressure drop from the left chamber corresponding to the cardiac output to the ascending aortic segment is directly obtained according to the simulation analysis result, the error caused by the simplification of a pressure difference calculation formula is avoided, the error caused by a certain angle between an ultrasonic beam and the measurement blood flow direction is avoided, the obtained pressure drop from the left chamber to the ascending aortic segment is more accurate, the obtained heart obstruction coefficient is more accurate, the severity of left-chamber outflow obstruction and aortic valve stenosis can be estimated more accurately, and the problem that the parameter values for estimating the left-chamber outflow obstruction and the aortic valve stenosis are inaccurate at present is solved.
Based on the same conception, the embodiment of the application provides a device for acquiring heart obstruction coefficient based on 4D-CTA and CFD, the specific implementation of the device can be referred to the description of the embodiment part of the method, and the repetition is omitted, as shown in FIG. 8, the device mainly comprises:
a first generation module 801, configured to acquire a 4D-CTA image, and generate a local blood flow cavity three-dimensional model according to the 4D-CTA image;
the second generating module 802 is configured to perform CFD simulation analysis on the local blood flow cavity three-dimensional model, and generate a simulation analysis result;
the obtaining module 803 is configured to obtain a pressure drop from the left chamber to the ascending aorta segment, where the pressure drop corresponds to the cardiac output, according to the simulation analysis result;
a processing module 804 for obtaining a heart obstruction factor from the cardiac output and the left ventricular chamber to ascending aortic segment pressure drop, wherein the heart obstruction factor is used to evaluate the severity of left ventricular outflow obstruction and aortic valve stenosis.
In a specific embodiment, the second generating module includes:
the first acquisition submodule is used for acquiring N cardiac output, wherein N is an integer greater than 1, the N cardiac output is a set value, and the N cardiac output is different;
and the first processing submodule is used for carrying out CFD simulation analysis on the three-dimensional model of the local blood flow cavity according to the N cardiac output quantities to generate a simulation analysis result.
In a specific embodiment, the acquiring module includes:
the second acquisition submodule is used for acquiring the left ventricular cavity pressure corresponding to the cardiac output and the ascending aorta pressure corresponding to the cardiac output according to the simulation analysis result;
and the second processing sub-module is used for subtracting the ascending aorta pressure corresponding to the cardiac output from the left chamber pressure corresponding to the cardiac output to obtain the pressure drop from the left chamber corresponding to the cardiac output to the ascending aorta segment.
In a specific embodiment, the second acquisition sub-module includes:
the first acquisition unit is used for acquiring M first pressure values corresponding to the cardiac output in the left chamber area according to the simulation analysis result, wherein M is an integer greater than 1;
a first processing unit, configured to calculate an average value of the M first pressure values, and use the average value of the M first pressure values as a left chamber pressure corresponding to the cardiac output;
the second acquisition unit is used for acquiring M second pressure values corresponding to the cardiac output in the ascending aorta region according to the simulation analysis result;
and the second processing unit is used for calculating the average value of the M second pressure values and taking the average value of the M second pressure values as the ascending aorta pressure corresponding to the cardiac output.
In one embodiment, a processing module includes:
a third processing sub-module for calculating a square value of the cardiac output;
and a fourth processing submodule, configured to divide the pressure drop from the left chamber to the ascending aortic segment by the square value to obtain a heart obstruction coefficient.
It should be noted that in this document, relational terms such as "first" and "second" and the like are used solely to distinguish one entity or action from another entity or action without necessarily requiring or implying any actual such relationship or order between such entities or actions. Moreover, the terms "comprises," "comprising," or any other variation thereof, are intended to cover a non-exclusive inclusion, such that a process, method, article, or apparatus that comprises a list of elements does not include only those elements but may include other elements not expressly listed or inherent to such process, method, article, or apparatus. Without further limitation, an element defined by the phrase "comprising one … …" does not exclude the presence of other like elements in a process, method, article, or apparatus that comprises the element.
The foregoing is only a specific embodiment of the application to enable those skilled in the art to understand or practice the application. Various modifications to these embodiments will be readily apparent to those skilled in the art, and the generic principles defined herein may be applied to other embodiments without departing from the spirit or scope of the application. Thus, the present application is not intended to be limited to the embodiments shown herein but is to be accorded the widest scope consistent with the principles and novel features disclosed herein.
Claims (4)
1. A 4D-CTA and CFD based heart obstruction factor acquisition device comprising:
the first generation module is used for acquiring a 4D-CTA image and generating a local blood flow cavity three-dimensional model according to the 4D-CTA image;
the second generation module is used for carrying out CFD simulation analysis on the local blood flow cavity three-dimensional model and generating a simulation analysis result;
the acquisition module is used for acquiring the pressure drop from the left chamber to the ascending aorta section corresponding to the cardiac output according to the simulation analysis result;
a processing module for obtaining a heart obstruction factor from the cardiac output and the left ventricular chamber to ascending aortic segment pressure drop, wherein the heart obstruction factor is used for evaluating the severity of left ventricular outflow obstruction and aortic valve stenosis; the processing module specifically comprises: a third processing sub-module for calculating a square value of the cardiac output; and a fourth processing submodule, configured to divide the pressure drop from the left chamber to the ascending aortic segment by the square value to obtain a heart obstruction coefficient.
2. The 4D-CTA and CFD based heart obstruction factor acquisition device of claim 1 wherein the second generation module comprises:
the first acquisition submodule is used for acquiring N cardiac output, wherein N is an integer greater than 1, the N cardiac output is a set value, and the N cardiac output is different;
and the first processing submodule is used for carrying out CFD simulation analysis on the three-dimensional model of the local blood flow cavity according to the N cardiac output quantities to generate a simulation analysis result.
3. The 4D-CTA and CFD based heart obstruction factor acquisition device of claim 2, wherein the acquisition module comprises:
the second acquisition submodule is used for acquiring the left ventricular cavity pressure corresponding to the cardiac output and the ascending aorta pressure corresponding to the cardiac output according to the simulation analysis result;
and the second processing sub-module is used for subtracting the ascending aorta pressure corresponding to the cardiac output from the left chamber pressure corresponding to the cardiac output to obtain the pressure drop from the left chamber corresponding to the cardiac output to the ascending aorta segment.
4. The 4D-CTA and CFD based heart obstruction factor acquisition device of claim 3 wherein the second acquisition sub-module comprises:
the first acquisition unit is used for acquiring M first pressure values corresponding to the cardiac output in the left chamber area according to the simulation analysis result, wherein M is an integer greater than 1;
a first processing unit, configured to calculate an average value of the M first pressure values, and use the average value of the M first pressure values as a left chamber pressure corresponding to the cardiac output;
the second acquisition unit is used for acquiring M second pressure values corresponding to the cardiac output in the ascending aorta region according to the simulation analysis result;
and the second processing unit is used for calculating the average value of the M second pressure values and taking the average value of the M second pressure values as the ascending aorta pressure corresponding to the cardiac output.
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