CN116525071A - System for assessing aortic dissection distal remodeling based on pressure drift - Google Patents

System for assessing aortic dissection distal remodeling based on pressure drift Download PDF

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CN116525071A
CN116525071A CN202310419445.2A CN202310419445A CN116525071A CN 116525071 A CN116525071 A CN 116525071A CN 202310419445 A CN202310419445 A CN 202310419445A CN 116525071 A CN116525071 A CN 116525071A
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aortic
pressure
remodeling
instantaneous
module
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方坤
舒畅
赵嘉伟
罗明尧
陈学慧
杨伟东
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Fuwai Hospital of CAMS and PUMC
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Fuwai Hospital of CAMS and PUMC
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/02Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
    • A61B5/02007Evaluating blood vessel condition, e.g. elasticity, compliance
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/05Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves 
    • A61B5/055Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves  involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/48Other medical applications
    • A61B5/4848Monitoring or testing the effects of treatment, e.g. of medication
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment
    • A61B6/02Devices for diagnosis sequentially in different planes; Stereoscopic radiation diagnosis
    • A61B6/03Computerised tomographs
    • A61B6/032Transmission computed tomography [CT]
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/08Detecting organic movements or changes, e.g. tumours, cysts, swellings
    • A61B8/0891Detecting organic movements or changes, e.g. tumours, cysts, swellings for diagnosis of blood vessels
    • GPHYSICS
    • G06COMPUTING; CALCULATING OR COUNTING
    • G06FELECTRIC DIGITAL DATA PROCESSING
    • G06F30/00Computer-aided design [CAD]
    • G06F30/20Design optimisation, verification or simulation
    • G06F30/28Design optimisation, verification or simulation using fluid dynamics, e.g. using Navier-Stokes equations or computational fluid dynamics [CFD]
    • GPHYSICS
    • G06COMPUTING; CALCULATING OR COUNTING
    • G06TIMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T17/00Three dimensional [3D] modelling, e.g. data description of 3D objects
    • GPHYSICS
    • G06COMPUTING; CALCULATING OR COUNTING
    • G06TIMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T7/00Image analysis
    • G06T7/0002Inspection of images, e.g. flaw detection
    • G06T7/0012Biomedical image inspection
    • GPHYSICS
    • G16INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16HHEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H30/00ICT specially adapted for the handling or processing of medical images
    • GPHYSICS
    • G06COMPUTING; CALCULATING OR COUNTING
    • G06FELECTRIC DIGITAL DATA PROCESSING
    • G06F2113/00Details relating to the application field
    • G06F2113/08Fluids
    • GPHYSICS
    • G06COMPUTING; CALCULATING OR COUNTING
    • G06FELECTRIC DIGITAL DATA PROCESSING
    • G06F2119/00Details relating to the type or aim of the analysis or the optimisation
    • G06F2119/14Force analysis or force optimisation, e.g. static or dynamic forces
    • YGENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y02TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
    • Y02TCLIMATE CHANGE MITIGATION TECHNOLOGIES RELATED TO TRANSPORTATION
    • Y02T90/00Enabling technologies or technologies with a potential or indirect contribution to GHG emissions mitigation

Abstract

A system for assessing aortic dissection distal remodeling based on pressure drift, comprising: the image data acquisition module is configured to acquire medical image data of human aorta before operation and after TEVAR operation of a patient to be evaluated; a model construction module configured to construct a three-dimensional anatomical model of the human aorta; the positioning point selection module is configured to select at least 6 positioning points at the far end of the aortic dissection; the area dividing module is configured to make a section in the normal direction corresponding to the positioning point and separate a real cavity area and a false cavity area of the section; the hydrodynamic analysis module is configured to acquire the instantaneous surface average pressure of the true cavity area and the false cavity area of each positioning point; the pressure drift curve module is configured to calculate the average pressure difference of the instantaneous surface between the true cavity area and the false cavity area of the positioning point and draw a pressure drift curve; and a remodeling evaluation module configured to evaluate the effect of aortic dissection distal remodeling. The invention can accurately evaluate the remodelling effect of the TEVAR operation on the distal end of the aortic dissection, and improves the decision-making efficiency of doctors.

Description

System for assessing aortic dissection distal remodeling based on pressure drift
Technical Field
The invention belongs to the field of biomedical engineering, and particularly relates to a system for evaluating distal remodeling of aortic dissection based on pressure drift.
Background
Stanford Type B Aortic Dissection (TBAD) refers to a tear in the intima of the aorta distal to the aortic arch, blood entering the media from the lacerations separates the layers of the aortic wall, creating a true and false separation of the two lumens, the most common aortic syndrome. The disease has the sudden onset, the incidence is increased, the mortality rate is extremely high, and clinical importance is increasingly drawn in recent years. Clinically, thoracic aortic endoluminal prostheses (TEVAR) are commonly used to treat TBAD by expanding a pressurized true lumen by occluding a proximal tear port to improve aortic blood flow.
Due to the complexity of the aortic dissection distal breach, clinicians typically choose multiple treatment protocols, which also complicates the assessment of aortic dissection distal remodeling. However, the effect of remodeling at the distal end of the dissection directly affects perfusion of downstream targeted organs.
Thus, there is a need in the art for an efficient and accurate system for assessing remodeling of the distal aortic dissection.
Disclosure of Invention
The invention aims to provide a system for evaluating distal remodeling of aortic dissection based on pressure drift, which aims to solve the problem of how to accurately evaluate the remodelling effect of TEVAR operation on distal remodeling of aortic dissection and provides reference for decision making of doctors.
In order to achieve the above purpose, the invention adopts the following technical scheme:
a system for assessing aortic dissection distal remodeling based on pressure drift, the system comprising:
the image data acquisition module is configured to acquire medical image data of human aorta in a preset time period before operation and after TEVAR operation of a patient to be evaluated;
a model construction module configured to construct a human aortic three-dimensional anatomical model of the patient under evaluation based on the medical image data, wherein the human aortic three-dimensional anatomical model comprises an aortic inlet to iliac artery branch;
the positioning point selection module is configured to select at least 6 positioning points at the far end of the aortic dissection based on the three-dimensional anatomical model of the human body aortic;
the region dividing module is configured to make a section in the normal direction of the aortic centerline corresponding to the positioning point and separate a real cavity region and a false cavity region of the section;
the hydrodynamic analysis module is configured to carry out hemodynamic analysis on the three-dimensional anatomical model of the human aorta and acquire the instantaneous surface average pressure of the true cavity area and the false cavity area corresponding to each positioning point;
the pressure drift curve module is configured to calculate the average pressure difference of the instantaneous surface between the real cavity areas corresponding to the positioning points and draw a pressure drift curve;
and the remodeling evaluation module is used for evaluating the effect of distal remodeling of the aortic dissection based on the pressure drift curve.
Preferably, the flow dynamics analysis module includes:
a boundary condition determining unit configured to use clinically measured flow and velocity data of the aortic inlet as boundary conditions of the aortic inlet; adopting the pressure boundary condition of the aortic outlet as the boundary condition of the aortic outlet;
the hemodynamic operation unit is configured to monitor flow data of an aortic outlet in real time, and finish operation when the flow data in adjacent cardiac cycles are converged to acquire hemodynamic parameters corresponding to the last cardiac cycle;
and the instantaneous plane average pressure calculation unit is configured to calculate instantaneous plane average pressures of the real cavity area and the false cavity area corresponding to the locating point based on the hemodynamic parameters.
Preferably, the instantaneous face average pressure operation unit is further configured to perform the following operations:
calculating the instantaneous surface average pressure of the true cavity area and the false cavity area corresponding to the positioning point according to the following method:
wherein P represents the instantaneous pressure of the true or false cavity region, A represents the cross-sectional area of the true or false cavity region, and P represents the instantaneous face average pressure of the true or false cavity region.
Preferably, the pressure drift curve module is further configured to perform the following operations:
subtracting the instantaneous surface average pressure of the real cavity area from the instantaneous surface average pressure of the false cavity area for each positioning point to obtain the instantaneous surface average pressure difference between the real cavity area and the false cavity area corresponding to each positioning point in a non-use period;
drawing a pressure drift curve based on the average pressure difference of the instantaneous surfaces of the true and false cavity areas corresponding to each positioning point in different periods; the abscissa of the pressure drift curve is the average pressure difference of the instantaneous surfaces between the true cavity region and the false cavity region, the ordinate of the pressure drift curve is the position of a locating point, and coordinate points corresponding to the locating points in the same period are sequentially connected to form the pressure drift curve.
Preferably, the positioning point at least comprises diaphragm level, abdominal cavity dry artery opening level, superior mesenteric artery opening level, renal artery opening level, abdominal aortic middle section level and abdominal aortic bifurcation level.
Preferably, the remodeling assessment module is further configured to: and acquiring dominant positions between the true and false cavity areas based on the instantaneous surface average pressure difference between the true and false cavity areas of the locating point, wherein the dominant positions represent the true cavity areas when the instantaneous surface average pressure difference is negative, and the dominant positions represent the false cavity areas when the instantaneous surface average pressure difference is positive.
Preferably, the model building module includes:
a threshold segmentation unit configured to obtain a preliminary mask of the human aorta based on the medical image data and by using a threshold segmentation method;
a tissue separation unit configured to separate an aortic blood vessel from other tissues of the human body by a three-dimensional segmentation and region growing method;
the primary model generating unit is configured to select main and far-end rupture of the aortic dissection based on experience of a clinician, and plug small rupture or inflammation part which is not related to the main and far-end rupture and generate a three-dimensional anatomical model of the human aorta;
the model denoising unit is configured to denoise the three-dimensional anatomical model of the human aorta so as to finish preliminary smoothing;
and the final model generating unit is configured to perform secondary smoothing and surface slicing treatment on the three-dimensional anatomical model of the human aorta to obtain the final three-dimensional anatomical model of the human aorta.
Preferably, the imaging modality of the medical image data comprises computed tomography CTA, nuclear magnetic resonance imaging, angiography, ultrasound imaging.
Preferably, the three-dimensional anatomical model of the human aorta is a numerical simulation model.
The invention has the advantages that:
according to the system for evaluating the distal remodeling of the aortic dissection based on pressure drift, provided by the invention, a three-dimensional anatomical model of a human body aortic is established, a plurality of positioning points are selected at the distal end of the aortic dissection, a real cavity area and a false cavity area are separated from each other at the positioning points, instantaneous surface pressure differences of the real cavity area and the false cavity area at each positioning point are analyzed and calculated through blood flow dynamics, and a pressure drift curve is drawn by utilizing the instantaneous surface pressure differences, so that the distal remodeling effect of the aortic dissection is evaluated, and the decision efficiency of doctors is improved.
Drawings
FIG. 1 is a schematic diagram of a system for assessing aortic dissection distal remodeling based on pressure drift in accordance with the present invention;
FIG. 2 is a schematic diagram of a three-dimensional anatomical model construction of the human aorta of a patient to be evaluated;
FIG. 3 is a schematic diagram of a model building block;
FIG. 4 is a schematic representation of a three-dimensional anatomical model of the human aorta of a patient to be evaluated, pre-operative, post-operative, and one-year follow-up;
FIG. 5 is a schematic view of setpoint selection of a patient to be evaluated;
FIG. 6 is a schematic cross-sectional view of a true and false lumen region of a patient to be evaluated at a location;
FIG. 7 is a schematic diagram of a flow dynamics analysis module;
fig. 8 is a graph of pressure drift for a patient to be evaluated during different time periods before and after surgery.
Detailed Description
The present embodiments provide a system for assessing aortic dissection distal remodeling based on pressure drift, which characterizes distal remodeling by assessing pressure differences between true and false lumens of the distal aortic dissection. The system for assessing aortic dissection distal remodeling based on pressure drift provided in this embodiment is described in further detail below with reference to the accompanying drawings.
Referring to fig. 1, fig. 1 illustrates the main structure of a system for assessing aortic dissection distal remodeling based on pressure drift. As shown in fig. 1, the system for assessing aortic dissection distal remodeling based on pressure drift provided in this embodiment includes: the system comprises an image data acquisition module 1, a model construction module 2, a positioning point selection module 3, a region division module 4, a hydrodynamic analysis module 5, a pressure drift curve module 6 and a remodeling evaluation module 7.
The image data acquisition module 1 is configured to acquire medical image data of the human aorta in a preset time period before and after the operation of the patient to be evaluated.
Specifically, medical images of the human aorta require selection of data from the same patient prior to surgery, post-surgery, and for a period of follow-up (e.g., 1 year). These medical image data may be any type of medical imaging modality. For example, computed tomography CTA, nuclear magnetic resonance imaging, angiography, ultrasound imaging, and the like. The present embodiment employs computed tomography CTA medical image data.
A model construction module 2 configured to construct a three-dimensional anatomical model of the human aorta of the patient to be evaluated based on the medical image data.
As shown in fig. 2, a vascular model was reconstructed in the mics 19.0. Specifically, the medical image data includes other human tissue in addition to the aortic portion, the aorta is separated from the other human tissue by establishing a threshold, and the finally reconstructed three-dimensional anatomical model of the human aorta includes the aortic inlet to iliac artery branches, i.e. includes the aortic inlet section to the iliac artery branches.
Referring to fig. 3, the model building module 2 specifically includes the following structure:
the threshold segmentation unit 21 is configured to obtain a preliminary mask of the human aorta based on the medical image data and by using a threshold segmentation method.
The tissue separation unit 22 is configured to separate the aortic blood vessel from other tissues of the human body by three-dimensional segmentation and region growing.
The preliminary model generating unit 23 is configured to select the main and distal aortic dissection based on the experience of the clinician, and to block the small dissection or inflammation part not related to the main and distal dissection and generate the three-dimensional anatomical model of the human aorta.
The model denoising unit 24 is configured to denoise the three-dimensional anatomical model of the human aorta to complete the preliminary smoothing.
And the final model generating unit is configured to perform secondary smoothing and surface slicing treatment on the three-dimensional anatomical model of the human aorta to obtain the final three-dimensional anatomical model of the human aorta.
Referring to fig. 4, a three-dimensional anatomical model of 3 human aorta was constructed according to the acquired medical image data of the preoperative and the two follow-up visits within one year after the TEVAR operation in this embodiment. In fig. 4, the three-dimensional anatomical models of the human aorta before operation, the first visit and the second visit are respectively corresponding from left to right.
The positioning point selecting module 3 is configured to select at least 6 positioning points at the distal end of the aortic dissection based on the three-dimensional anatomical model of the human aortic artery.
Specifically, at least 6 positioning points are selected at the far end of the aortic dissection of the human body, wherein the positioning points are respectively (1) diaphragmatic muscle level; (2) the abdominal cavity dry artery opening level; (3) superior mesenteric artery opening level; (4) renal artery opening level; (5) mid-abdominal aortic level (renal artery ostium-mid-abdominal aortic bifurcation level); (6) level of abdominal aortic bifurcation. As shown in fig. 5, a schematic diagram of a selected model of the anchor point is shown, and the line mark in fig. 5 is the position of the anchor point. It should be noted that a greater number of anchor points may be provided in order to improve the calculation accuracy.
The area dividing module 4 is configured to make a section in the normal direction corresponding to the positioning point and separate a real cavity area and a false cavity area of the section. Specifically, sections are respectively made on the positioning points based on the normal direction of the central line of the aorta, and real and false cavity areas on the sections are separated. As shown in fig. 6, a schematic cross-sectional view of the real and false cavity area during post-processing according to the anchor point is shown.
The flow mechanics analysis module 5 is configured to perform a blood dynamics analysis on the three-dimensional anatomical model of the human aorta, and acquire the instantaneous surface average pressures of the real cavity area and the false cavity area corresponding to each positioning point.
Specifically, to evaluate the accuracy of the results, clinically measured aortic inlet flow and velocity data may be employed as boundary conditions for the aortic inlet. The pressure boundary condition of the aortic outlet is used as the boundary condition for the aortic outlet. And monitoring the flow data of the aortic outlet in real time, and ending the operation when the flow data in the adjacent cardiac cycles are converged, namely ending the operation when the flow changes of the previous cardiac cycle and the next cardiac cycle are basically unchanged. And acquiring the hemodynamic parameters corresponding to the last cardiac cycle. And calculating the instantaneous surface average pressure of the real cavity area and the false cavity area corresponding to the positioning point based on the hemodynamic parameters.
Referring to fig. 7, the fluid mechanics analysis module 5 includes: a boundary condition determining unit 21 configured to use clinically measured flow and velocity data of the aortic inlet as boundary conditions of the aortic inlet; adopting the pressure boundary condition of the aortic outlet as the boundary condition of the aortic outlet; the hemodynamic operation unit 22 is configured to monitor flow data of an aortic outlet in real time, and end operation when the flow data in adjacent cardiac cycles are converged, so as to obtain hemodynamic parameters corresponding to the last cardiac cycle; an instantaneous plane average pressure calculation unit 23 configured to calculate instantaneous plane average pressures of the true and false lumen regions corresponding to the anchor points based on the hemodynamic parameters.
Wherein the instantaneous plane average pressure calculation unit 23 is further configured to calculate instantaneous plane average pressures of the true cavity region and the false cavity region corresponding to the anchor point according to a method shown in formula (1):
wherein P represents the instantaneous pressure of the true or false cavity region, A represents the cross-sectional area of the true or false cavity region, and P represents the instantaneous face average pressure of the true or false cavity region.
And the pressure drift curve module 6 is configured to calculate the instantaneous plane average pressure difference between the true and false cavity areas corresponding to the positioning points and draw a pressure drift curve.
Specifically, subtracting the instantaneous surface average pressure of the real cavity region from the instantaneous surface average pressure of the false cavity region for each positioning point to obtain the instantaneous surface average pressure difference between the real and false cavity regions corresponding to each positioning point in a non-use period, namely, calculating the pressure difference between the real and false cavities on the section of each positioning point asWherein (1)>Representing the instantaneous face average pressures of the false and true chambers, respectively. Drawing a pressure drift curve based on the average pressure difference of the instantaneous surfaces of the true and false cavity areas corresponding to each positioning point in different periods; as shown in fig. 6, the abscissa of the pressure drift curve is the average pressure difference of the instantaneous plane between the real and false cavity regions, the ordinate of the pressure drift curve is the sequential positions of the positioning points, and the coordinate points corresponding to each positioning point in the same period are sequentially connected to form the pressure drift curve.
A remodeling evaluation module 7 for evaluating the effect of aortic dissection distal remodeling based on the pressure drift curve.
Based on the instantaneous surface average pressure difference between the true and false cavity areas of the positioning points, the dominant position between the true and false cavity areas is obtained, namely the remote remodeling effect is analyzed according to the dominant position of the true and false cavity pressure. Wherein the real cavity region is dominant when the instantaneous face average pressure difference is negative, and the false cavity region is dominant when the instantaneous face average pressure difference is positive. Through the pressure drift curve, a doctor can obtain the effect of distal aortic dissection remodeling before operation, after operation and in the follow-up time period, and the decision efficiency of the doctor is improved.
The following describes the execution flow of the system for assessing aortic dissection distal remodeling based on pressure drift according to the embodiment of the present invention in detail.
The patient pre-operative, TEVAR post-operative and annual follow-up medical image data is selected, in this example computed tomography CTA medical image data. As shown in fig. 2, the selected medical image data is imported into a mics19.0 (materiai, belgium) for three-dimensional reconstruction of the patient CT. As shown in fig. 4, the three-dimensional anatomical model of the human aorta of the patient to be evaluated is a three-dimensional anatomical model of the human aorta of the first visit before and the second visit after the operation from left to right.
The specific steps of building the model are as follows: firstly, patient DICOM data are imported into software, and a region of interest is segmented out through selecting a certain threshold range. The irrelevant areas are further deleted in large areas by means of a 3D lock kit, and then an aortic image is acquired through a software area growth function. Since the aortic image noise is still large at this time, a finer adjustment is required, and extraneous tissue near the aorta is deleted by means of an erasure tool in the chemicals. Notably, identification of the lacerations should be discussed in advance with the clinician in determining the location of the primary lacerations, plugging small lacerations or inflammatory components that are not relevant. The true and false lumens are further separated to facilitate the calculation of the subsequent pressure difference. After the steps, a preliminary model can be obtained. And 3D models are calculated after smoothing processing by using a smoothing tool and are exported into an STL format. Because the model at this time is a triangular patch model, the model needs to be imported into a geomagicstuio for surface patch processing, firstly, a grid doctor is utilized to process the abnormality of the model, and further, the three-dimensional model is subjected to grating by drawing the outline of the aorta, and finally, a surface patch format is generated and exported as an STP model.
The established aortic STP model is imported into simulation software (ANSYS). First, to eliminate the influence of the geometric boundary on the calculation result, an expansion operation is performed on all downstream branches of the model (10 times the expansion radius of each branch vessel). Mesh division is then performed in a mesh automation generator using ANSYS MESH (ANSYS Inc, canonsburg, USA), in this example an unstructured mesh is used. After setting the global variable parameters and boundary layer parameters, the software automatically draws unstructured grids. The core is a tetrahedral unit, and 6 layers of prismatic boundary layer grids are divided near the aortic wall. Hemodynamic simulations were then performed in FLUENT.
Subsequently, as shown in fig. 5, for each model of the patient to be evaluated, no less than 6 anchor points are selected at the distal end of the aortic dissection. Based on these anchor points, the method proceeds in post-processing software to a directional section, separates the true and false cavity areas on the section, and calculates the instantaneous face average pressures of the true and false cavity areas, respectively, as shown in fig. 6. Subtracting the instantaneous surface average pressure on the real cavity side from the instantaneous surface average pressure on the false cavity side to obtain the real and false cavity pressure difference at each section, drawing a pressure drift curve by the pressure differences on the sections, and analyzing the pressure difference trend of the patient at each follow-up stage after the TEVAR operation. As shown in fig. 8, the present embodiment plots the pressure drift curves of the distal aortic dissection of a patient during two follow-up operations before and after the operation, and it can be found that the pressure difference of the patient before the operation is positive, which indicates that the prosthetic cavity is dominant, and after TEVAR, the pressure difference in the two follow-up operations is negative, and the pressure difference in the second follow-up operation is greater than the pressure difference in the first follow-up operation, which indicates that the distal aortic dissection of the TEVAR is dominant, which is beneficial to the remodeling of the distal real cavity.
Those of skill in the art will appreciate that the various illustrative systems and method steps described in connection with the embodiments disclosed herein may be implemented as electronic hardware, computer software, or combinations of both, and that the various illustrative components and steps have been described above generally in terms of functionality in order to clearly illustrate the interchangeability of electronic hardware and software. Whether such functionality is implemented as electronic hardware or software depends upon the particular application and design constraints imposed on the solution. Those skilled in the art may implement the described functionality using different approaches for each particular application, but such implementation is not intended to be limiting.
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/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/apparatus.
The foregoing is a description of the preferred embodiments of the present invention and the technical principles applied thereto, and it will be apparent to those skilled in the art that any equivalent transformation, simple substitution, etc. based on the technical scheme of the present invention can be made without departing from the spirit and scope of the present invention.

Claims (9)

1. A system for assessing aortic dissection distal remodeling based on pressure drift, the system comprising:
the image data acquisition module is configured to acquire medical image data of human aorta in a preset time period before operation and after TEVAR operation of a patient to be evaluated;
a model construction module configured to construct a human aortic three-dimensional anatomical model of the patient under evaluation based on the medical image data, wherein the human aortic three-dimensional anatomical model comprises an aortic inlet to iliac artery branch;
the positioning point selection module is configured to select at least 6 positioning points at the far end of the aortic dissection based on the three-dimensional anatomical model of the human body aortic;
the region dividing module is configured to make a section in the normal direction of the aortic centerline corresponding to the positioning point and separate a real cavity region and a false cavity region of the section;
the hydrodynamic analysis module is configured to carry out hemodynamic analysis on the three-dimensional anatomical model of the human aorta and acquire the instantaneous surface average pressure of the true cavity area and the false cavity area corresponding to each positioning point;
the pressure drift curve module is configured to calculate the average pressure difference of the instantaneous surface between the real cavity areas corresponding to the positioning points and draw a pressure drift curve;
and the remodeling evaluation module is used for evaluating the effect of distal remodeling of the aortic dissection based on the pressure drift curve.
2. The system for assessing aortic dissection distal remodeling based on pressure drift of claim 1, wherein the flow mechanical analysis module comprises:
a boundary condition determining unit configured to use clinically measured flow and velocity data of the aortic inlet as boundary conditions of the aortic inlet; adopting the pressure boundary condition of the aortic outlet as the boundary condition of the aortic outlet;
the hemodynamic operation unit is configured to monitor flow data of an aortic outlet in real time, and finish operation when the flow data in adjacent cardiac cycles are converged to acquire hemodynamic parameters corresponding to the last cardiac cycle;
and the instantaneous plane average pressure calculation unit is configured to calculate instantaneous plane average pressures of the real cavity area and the false cavity area corresponding to the locating point based on the hemodynamic parameters.
3. The system for assessing aortic dissection distal remodeling based on pressure drift of claim 2, wherein the instantaneous surface average pressure calculation unit is further configured to:
calculating the instantaneous surface average pressure of the true cavity area and the false cavity area corresponding to the positioning point according to the following method:
wherein P represents the instantaneous pressure in the true or false cavity region, A represents the cross-sectional area of the true or false cavity region,representing the instantaneous face average pressure in the true or false chamber region.
4. The system for assessing aortic dissection distal remodeling based on pressure drift of claim 3, wherein the pressure drift profile module is further configured to:
subtracting the instantaneous surface average pressure of the real cavity area from the instantaneous surface average pressure of the false cavity area for each positioning point to obtain the instantaneous surface average pressure difference between the real cavity area and the false cavity area corresponding to each positioning point in a non-use period;
drawing a pressure drift curve based on the average pressure difference of the instantaneous surfaces of the true and false cavity areas corresponding to each positioning point in different periods; the abscissa of the pressure drift curve is the average pressure difference of the instantaneous surfaces between the true cavity region and the false cavity region, the ordinate of the pressure drift curve is the position of a locating point, and coordinate points corresponding to the locating points in the same period are sequentially connected to form the pressure drift curve.
5. The system for assessing aortic dissection distal remodeling based on pressure drift of claim 4, wherein the localization point is at least comprises diaphragm level, celiac dry arterial opening level, superior mesenteric arterial opening level, renal arterial opening level, mid-abdominal aortic level, and abdominal aortic bifurcation level.
6. The system for assessing aortic dissection distal remodeling based on pressure drift of claim 4, wherein the remodeling assessment module is further configured to: and acquiring dominant positions between the true and false cavity areas based on the instantaneous surface average pressure difference between the true and false cavity areas of the locating point, wherein the dominant positions represent the true cavity areas when the instantaneous surface average pressure difference is negative, and the dominant positions represent the false cavity areas when the instantaneous surface average pressure difference is positive.
7. The system for assessing aortic dissection distal remodeling based on pressure drift of claim 1, wherein the model building module comprises:
a threshold segmentation unit configured to obtain a preliminary mask of the human aorta based on the medical image data and by using a threshold segmentation method;
a tissue separation unit configured to separate an aortic blood vessel from other tissues of the human body by a three-dimensional segmentation and region growing method;
the primary model generating unit is configured to select main and far-end rupture of the aortic dissection based on experience of a clinician, and plug small rupture or inflammation part which is not related to the main and far-end rupture and generate a three-dimensional anatomical model of the human aorta;
the model denoising unit is configured to denoise the three-dimensional anatomical model of the human aorta so as to finish preliminary smoothing;
and the final model generating unit is configured to perform secondary smoothing and surface slicing treatment on the three-dimensional anatomical model of the human aorta to obtain the final three-dimensional anatomical model of the human aorta.
8. The system for assessing aortic dissection distal remodeling based on pressure drift of any one of claims 1 to 7, wherein the imaging modality of medical image data comprises computed tomography CTA, nuclear magnetic co-imaging, angiography, ultrasound imaging.
9. The system for assessing aortic dissection distal remodeling based on pressure drift of claim 8, wherein the human aortic three-dimensional anatomical model is a numerical simulation model.
CN202310419445.2A 2023-04-19 2023-04-19 System for assessing aortic dissection distal remodeling based on pressure drift Pending CN116525071A (en)

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