CN117414200B - System and method for preoperative exercise of heart surgical valve repair operation - Google Patents
System and method for preoperative exercise of heart surgical valve repair operation Download PDFInfo
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/08—Detecting organic movements or changes, e.g. tumours, cysts, swellings
- A61B8/0883—Detecting organic movements or changes, e.g. tumours, cysts, swellings for diagnosis of the heart
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
- A61B2034/101—Computer-aided simulation of surgical operations
- A61B2034/105—Modelling of the patient, e.g. for ligaments or bones
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
- A61B2034/107—Visualisation of planned trajectories or target regions
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
- A61B2034/108—Computer aided selection or customisation of medical implants or cutting guides
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- A—HUMAN NECESSITIES
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
- A61B2034/2046—Tracking techniques
- A61B2034/2063—Acoustic tracking systems, e.g. using ultrasound
Abstract
The invention discloses a system and a method for preoperative exercise of heart surgical valve repair surgery, which are applied to preoperative simulation technology, wherein the system comprises: an acquisition unit configured to acquire scan data and hemodynamic characteristic data; a modeling unit configured to construct a preoperative three-dimensional model; a modification unit configured to modify the three-dimensional model after the formation; and the calculation unit is configured to acquire the characteristic data of the key part and evaluate the operation scheme. The system and the method for preoperative exercise of heart surgical valve repair operation can screen an optimized operation scheme for an operator, guide the operation of the operator, help to avoid the occurrence of the condition of transthoracic secondary machine valve repair or replacement in operation, realize one-step in place, shorten operation time, reduce related complications caused by long-time extracorporeal circulation, provide a means for simulating evaluation for new technology and new operation type of valve repair, and help to explore the new operation type of valve repair formation.
Description
Technical Field
The invention relates to an operation simulation drilling technology, in particular to a system and a method for preoperative drilling of heart surgical valve repair operation.
Background
The heart surgical valve repair is mainly aimed at corrective operations of diseased valves such as valve prolapse, valve annulus dilation and the like, so as to realize normal opening and closing functions of the valves. The traditional heart surgery open chest operation needs to stop the heart completely under the assistance of extracorporeal circulation, open the heart cavity and repair the diseased valve. Valve repair shaping mainly involves the following 3 elements of the valve, a. Annulus diameter: simple valve regurgitation is often caused by an enlarged annulus diameter, and for this treatment, the size of the annuloplasty ring is often selected by preoperative esophageal echocardiography evaluation. b. Valve leaf: for the treatment of lengthy valve leaflet or the condition of the valve leaflet with bad coaptation, a folding suture mode is often adopted for treatment; c. chordae tendineae: the broken chordae are often repaired by adding artificial chordae. After the annuloplasty repair is completed, a conventional method for evaluating the annuloplasty repair effect is a water injection experiment, in which physiological saline is injected into the downstream heart chamber, and the annuloplasty repair effect is evaluated by observing the existence of regurgitation leakage of saline, the valvular coaptation condition and the diameter of the valve annulus.
However, such an evaluation means still has the following problems:
1. the water injection experiment is performed in a cardiac arrest state, which cannot completely simulate a physiological state (the state that each chamber of the heart completely and normally fills), and has hemodynamic parameter characteristics different from those of the physiological state (such as that the filling pressure of the left ventricle at the end of water injection is different from that of the left ventricle at the end of systole under the normal physiological condition, and secondly, the valve involution condition in the cardiac arrest state is possibly different from that in the arrest state, because the diameter and the shape of the valve annulus in the filling state of different degrees of each heart chamber are different from those in the cardiac arrest state, and the valve annulus shape and the valve leaflet involution condition in the empty state of the right heart system are not the same), so that the water injection experiment cannot completely and effectively evaluate the valve repair forming effect;
2. if the water injection experimental effect is still good in operation, but after heart recurrence, the eccentric reflux of the prosthetic valve occurs due to factors such as blood pressure, capacity load and the like, the valve repair condition is poor, and at the moment, a surgeon faces whether to stop the jumper again for secondary repair or declare repair failure, and the difficult choice of valve replacement is changed. The secondary stop jump machine can not prolong the operation time, the heart ischemia reperfusion time can affect the recovery of the heart function of the patient after the operation, and the long-time extracorporeal circulation can have serious influence on the coagulation system of the patient, even have complications such as postoperative hemostasis difficulty and the like.
In the prior art, the Chinese patent with application number 202310701366.0 discloses a simulation and navigation method and system for a bronchus foreign matter removal operation, wherein the method comprises the following steps: generating a tracheal tree segmentation mask corresponding to a trachea in the chest and a foreign object segmentation mask corresponding to a foreign object in the chest based on medical image data of the chest of the target object; generating a virtual scene based on the tracheal tree segmentation mask and the foreign object segmentation mask, wherein the virtual scene at least comprises a virtual tracheal corresponding to the trachea, a virtual foreign object corresponding to the foreign object and a virtual path corresponding to the advancing path of the bronchoscope; and providing surgical simulation and/or surgical navigation for the foreign object removal surgery based on the virtual scene. The scheme capable of performing operation simulation is provided, but due to the particularity of cardiac surgery, the dynamics simulation difficulty of the heart is far higher than that of a static bronchus, so that the simulation of the heart dynamics on the operation such as heart surgery valve repair and the like can realize accurate and effective operation implementation in the operation, and the operation time and the risks of related complications are reduced.
Disclosure of Invention
To overcome at least the above-mentioned deficiencies in the prior art, it is an object of the present application to provide a system and method for pre-operative exercise of heart surgical valve repair procedures.
In a first aspect, embodiments of the present application provide a system for preoperative exercise of heart surgical valve repair surgery, comprising:
the acquisition unit is configured to perform 3D ultrasonic detection on a target heart to obtain scanning data, and perform hemodynamic detection on the target heart to obtain hemodynamic characteristic data;
a modeling unit configured to construct a preoperative three-dimensional model from the scan data and the hemodynamic characteristic data;
a modification unit configured to modify the preoperative three-dimensional model according to a surgical scheme to form a post-operative three-dimensional model;
and the calculation unit is configured to calculate the postoperative three-dimensional model to obtain the characteristic data of the key part in the postoperative three-dimensional model, and evaluate the surgical scheme according to the characteristic data.
In the implementation of the embodiment of the present application, the scan data may be obtained through 3D ultrasonic detection, and may also be obtained through other approaches, such as X-ray scanning, cardiac nuclear magnetic resonance, and the above three acquisition modes are comprehensively obtained, which should be regarded as being equivalent to the 3D ultrasonic detection described herein; wherein the diseased valve is the subject of the data acquisition of interest. Since the heart is in motion, the scan data should also be data with timing. Meanwhile, the acquisition unit can acquire hemodynamic characteristic data through hemodynamic detection, corresponding means comprise noninvasive detection and puncture detection, and corresponding data can be acquired by a person skilled in the art according to requirements.
In the embodiment of the application, the preoperative three-dimensional model can be built based on commercial software related to a finite element method and a finite volume method, and the preoperative three-dimensional model can be built and operated by software such as matlab. It should be appreciated that the preoperative three-dimensional model is a dynamic model that requires simultaneous satisfaction of both scan data and hemodynamic characterization data, and performs multiple rounds of iterative convergence. Based on the preoperative three-dimensional model, the model is modified according to the operation scheme, such as the selection of different types of forming rings, the folding suturing of different positions of the redundant valve leaflet, the attempt of different folding degrees, the selection of the hanging position of the artificial chordae, and the like, the modification mode can be used for reassigning the attribute of the unit, the corresponding structure can be formed in the preoperative three-dimensional model, and the structure is activated in the modification, so that the embodiment of the application is not limited.
In the embodiment of the application, the hydrodynamic calculation is performed again based on the modified postoperative three-dimensional model, so that the hydrodynamic state possibly existing in the target heart after the operation of the corresponding operation scheme is performed can be simulated. The feasibility of the surgical procedure can be assessed by extracting feature data of key sites of the hydrodynamic state. Specifically, the characteristic data of the key part can be selected according to the needs, such as the valve opening and closing conditions, including the annular state size, the valve leaflet involution height and the like. According to the technical scheme, the optimized operation scheme can be screened out for an operator, the operator is guided to operate, the situation that the valve is repaired or replaced through the chest secondary transfer machine in operation is avoided, one-step in-place is achieved, operation time is shortened, related complications caused by long-time extracorporeal circulation are reduced, a means for simulating and evaluating is provided for a new valve repair technology and a new valve repair formula, and the new valve repair forming operation formula is explored.
In one possible implementation, the modeling unit is further configured to:
constructing an atrial structure, a ventricular structure, an annular structure, a leaflet structure and a chordae tendineae structure in diastole according to the scanning data to form a basic three-dimensional model;
acquiring inner diameter change data of an atrial structure and a ventricular structure in a cardiac cycle from the scan data as space change data, and acquiring position and size change data of an annular structure, a leaflet structure and a chorda tendineae structure in the cardiac cycle as space constraint data; the spatially varying data and the spatially constrained data are aligned along a temporal sequence;
acquiring flow velocity and pressure data at a fluid inlet and a fluid outlet in the basic three-dimensional model as boundary data according to the hemodynamic characteristic data, and acquiring fluid unit parameters according to the hemodynamic characteristic data;
filling fluid units in the structure of the basic three-dimensional model, assigning the fluid unit parameters to the fluid units, and assigning initial structure parameters to the structure units of the basic three-dimensional model to form an initial three-dimensional model;
constructing a displacement load spectrum according to the space change data, and constructing a constraint spectrum according to the space constraint data;
Performing initial assignment on a fluid inlet and outlet in the initial three-dimensional model, loading a central room structure and a ventricular structure of the initial three-dimensional model by taking the displacement load spectrum as a load, and simultaneously performing liquid-solid coupling dynamics calculation of the initial three-dimensional model by restricting displacement of an annular valve structure, a leaflet structure and a chordae tendineae structure by using the restriction spectrum;
if the fluid parameters of the fluid inlet and outlet in the initial three-dimensional model do not accord with the boundary data in the fluid-solid coupling dynamics calculation result, adjusting the assignment of the fluid unit and the structural unit and carrying out the fluid-solid coupling dynamics again until the fluid parameters of the fluid inlet and outlet in the initial three-dimensional model accord with the boundary data;
and if the fluid parameters of the fluid inlet and outlet in the initial three-dimensional model accord with the boundary data in the liquid-solid coupling dynamics calculation result, taking the initial three-dimensional model subjected to liquid-solid coupling dynamics calculation as the preoperative three-dimensional model.
In a possible implementation, the modification unit is further configured to:
and adjusting the attribute and parameters of the unit at the corresponding part in the preoperative three-dimensional model according to the surgical scheme to form the postoperative three-dimensional model.
In one possible implementation, the arithmetic unit is further configured to:
and adjusting the constraint spectrum according to an operation scheme, loading the central room structure and the ventricular structure of the three-dimensional postoperative model by taking the displacement load spectrum as a load, and carrying out liquid-solid coupling dynamics calculation of the three-dimensional postoperative model by using the adjusted displacement of the constraint spectrum to constrain the valve annulus structure, the valve leaflet structure and the chordae tendineae structure.
In one possible implementation, the arithmetic unit is further configured to:
obtaining a liquid-solid coupling dynamics calculation result of the postoperative three-dimensional model, and extracting fluid data and/or displacement deformation data of a corresponding key part from the result as the characteristic data;
when the characteristic data exceeds a preset value, judging that the corresponding operation scheme is unqualified;
and when the characteristic data does not exceed a preset value, judging that the corresponding operation scheme is qualified.
In a second aspect, embodiments of the present application provide a method for preoperative exercise of heart surgical valve repair surgery, comprising:
performing 3D ultrasonic detection on a target heart to obtain scanning data, and performing hemodynamic detection on the target heart to obtain hemodynamic characteristic data;
Constructing a preoperative three-dimensional model according to the scanning data and the hemodynamic characteristic data;
modifying the preoperative three-dimensional model according to an operation scheme to form a postoperative three-dimensional model;
calculating the postoperative three-dimensional model to obtain characteristic data of key parts in the postoperative three-dimensional model, and evaluating the operation scheme according to the characteristic data.
In one possible implementation, constructing a pre-operative three-dimensional model from the scan data and the hemodynamic characterization data includes:
constructing an atrial structure, a ventricular structure, an annular structure, a leaflet structure and a chordae tendineae structure in diastole according to the scanning data to form a basic three-dimensional model;
acquiring inner diameter change data of an atrial structure and a ventricular structure in a cardiac cycle from the scan data as space change data, and acquiring position and size change data of an annular structure, a leaflet structure and a chorda tendineae structure in the cardiac cycle as space constraint data; the spatially varying data and the spatially constrained data are aligned along a temporal sequence;
acquiring flow velocity and pressure data at a fluid inlet and a fluid outlet in the basic three-dimensional model as boundary data according to the hemodynamic characteristic data, and acquiring fluid unit parameters according to the hemodynamic characteristic data;
Filling fluid units in the structure of the basic three-dimensional model, assigning the fluid unit parameters to the fluid units, and assigning initial structure parameters to the structure units of the basic three-dimensional model to form an initial three-dimensional model;
constructing a displacement load spectrum according to the space change data, and constructing a constraint spectrum according to the space constraint data;
performing initial assignment on a fluid inlet and outlet in the initial three-dimensional model, loading a central room structure and a ventricular structure of the initial three-dimensional model by taking the displacement load spectrum as a load, and simultaneously performing liquid-solid coupling dynamics calculation of the initial three-dimensional model by restricting displacement of an annular valve structure, a leaflet structure and a chordae tendineae structure by using the restriction spectrum;
if the fluid parameters of the fluid inlet and outlet in the initial three-dimensional model do not accord with the boundary data in the fluid-solid coupling dynamics calculation result, adjusting the assignment of the fluid unit and the structural unit and carrying out the fluid-solid coupling dynamics again until the fluid parameters of the fluid inlet and outlet in the initial three-dimensional model accord with the boundary data;
and if the fluid parameters of the fluid inlet and outlet in the initial three-dimensional model accord with the boundary data in the liquid-solid coupling dynamics calculation result, taking the initial three-dimensional model subjected to liquid-solid coupling dynamics calculation as the preoperative three-dimensional model.
In one possible implementation, modifying the preoperative three-dimensional model according to a surgical scheme to form a post-operative three-dimensional model includes:
and adjusting the attribute and parameters of the unit at the corresponding part in the preoperative three-dimensional model according to the surgical scheme to form the postoperative three-dimensional model.
In one possible implementation, calculating the post-operative three-dimensional model includes:
and adjusting the constraint spectrum according to an operation scheme, loading the central room structure and the ventricular structure of the three-dimensional postoperative model by taking the displacement load spectrum as a load, and carrying out liquid-solid coupling dynamics calculation of the three-dimensional postoperative model by using the adjusted displacement of the constraint spectrum to constrain the valve annulus structure, the valve leaflet structure and the chordae tendineae structure.
In one possible implementation, obtaining the feature data of the key part in the three-dimensional postoperative model, and evaluating the surgical scheme according to the feature data includes:
obtaining a liquid-solid coupling dynamics calculation result of the postoperative three-dimensional model, and extracting fluid data and/or displacement deformation data of a corresponding key part from the result as the characteristic data;
when the characteristic data exceeds a preset value, judging that the corresponding operation scheme is unqualified;
And when the characteristic data does not exceed a preset value, judging that the corresponding operation scheme is qualified.
Compared with the prior art, the invention has the following advantages and beneficial effects:
according to the system and the method for preoperative exercise of heart surgical valve repair operation, through the technical scheme, an optimized operation scheme can be screened out for an operator, the operator is guided to operate, the situation that the valve repair or replacement is performed through a chest secondary rotating machine in operation is avoided, one-step in-place is realized, the operation time is shortened, related complications caused by long-time extracorporeal circulation are reduced, a means for simulating and evaluating a new technology and a new operation mode of valve repair is provided, and the new operation mode of valve repair forming is explored.
Drawings
The accompanying drawings, which are included to provide a further understanding of embodiments of the invention and are incorporated in and constitute a part of this application, illustrate embodiments of the invention. In the drawings:
FIG. 1 is a schematic diagram of a system architecture according to an embodiment of the present application;
FIG. 2 is a schematic diagram of the steps of the method 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 clear, 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 should be understood that the accompanying drawings in the present application are only for the purpose of illustration and description, and are not intended to limit the protection scope of the present application. In addition, it should be understood that the schematic drawings are not drawn to scale. A flowchart, as used in this application, illustrates operations implemented according to some embodiments of the present application. It should be understood that the operations of the flow diagrams may be implemented out of order and that steps without logical context may be performed in reverse order or concurrently. Moreover, one or more other operations may be added to the flow diagrams and one or more operations may be removed from the flow diagrams as directed by those skilled in the art.
In addition, the described embodiments are only some, but not all, of the embodiments of the present application. The components of the embodiments of the present application, which are generally described and illustrated in the figures herein, may be arranged and designed in a wide variety of different configurations. Thus, the following detailed description of the embodiments of the present application, as provided in the accompanying drawings, is not intended to limit the scope of the application, as claimed, but is merely representative of selected embodiments of the application. All other embodiments, which can be made by those skilled in the art based on the embodiments of the present application without making any inventive effort, are intended to be within the scope of the present application.
In order to facilitate the description of a system for preoperative exercise of a heart surgical valve repair procedure described above, please refer to fig. 1 in combination, a schematic diagram of a communication architecture of a system for preoperative exercise of a heart surgical valve repair procedure disclosed in an embodiment of the present invention is provided. The method comprises the following steps:
the acquisition unit is configured to perform 3D ultrasonic detection on a target heart to obtain scanning data, and perform hemodynamic detection on the target heart to obtain hemodynamic characteristic data;
a modeling unit configured to construct a preoperative three-dimensional model from the scan data and the hemodynamic characteristic data;
A modification unit configured to modify the preoperative three-dimensional model according to a surgical scheme to form a post-operative three-dimensional model;
and the calculation unit is configured to calculate the postoperative three-dimensional model to obtain the characteristic data of the key part in the postoperative three-dimensional model, and evaluate the surgical scheme according to the characteristic data.
When the embodiment of the application is implemented, the scan data can be obtained through 3D ultrasonic detection, and can also be obtained through other approaches, such as X-ray scanning, which should be regarded as being equivalent to 3D ultrasonic detection; wherein the diseased valve is the subject of the data acquisition of interest. Since the heart is in motion, the scan data should also be data with timing. Meanwhile, the acquisition unit can acquire hemodynamic characteristic data through hemodynamic detection, corresponding means comprise noninvasive detection and puncture detection, and corresponding data can be acquired by a person skilled in the art according to requirements.
In the embodiment of the application, the preoperative three-dimensional model can be built based on commercial software related to a finite element method and a finite volume method, and the preoperative three-dimensional model can be built and operated by software such as matlab. It should be appreciated that the preoperative three-dimensional model is a dynamic model that requires simultaneous satisfaction of both scan data and hemodynamic characterization data, and performs multiple rounds of iterative convergence. Based on the preoperative three-dimensional model, the model is modified according to the operation scheme, such as the selection of different types of forming rings, the folding suturing of different positions of the redundant valve leaflet, the attempt of different folding degrees, the selection of the hanging position of the artificial chordae, and the like, the modification mode can be used for reassigning the attribute of the unit, the corresponding structure can be formed in the preoperative three-dimensional model, and the structure is activated in the modification, so that the embodiment of the application is not limited.
In the embodiment of the application, the hydrodynamic calculation is performed again based on the modified postoperative three-dimensional model, so that the hydrodynamic state possibly existing in the target heart after the operation of the corresponding operation scheme is performed can be simulated. The feasibility of the surgical procedure can be assessed by extracting feature data of key sites of the hydrodynamic state. Specifically, the characteristic data of the key part can be selected according to the needs, such as the valve opening and closing conditions, including the annular state size, the valve leaflet involution height and the like. According to the technical scheme, the optimized operation scheme can be screened out for an operator, the operator is guided to operate, the situation that the valve is repaired or replaced through the chest secondary transfer machine in operation is avoided, one-step in-place is achieved, operation time is shortened, related complications caused by long-time extracorporeal circulation are reduced, a means for simulating and evaluating is provided for a new valve repair technology and a new valve repair formula, and the new valve repair forming operation formula is explored.
In one possible implementation, the modeling unit is further configured to:
constructing an atrial structure, a ventricular structure, an annular structure, a leaflet structure and a chordae tendineae structure in diastole according to the scanning data to form a basic three-dimensional model;
Acquiring inner diameter change data of an atrial structure and a ventricular structure in a cardiac cycle from the scan data as space change data, and acquiring position and size change data of an annular structure, a leaflet structure and a chorda tendineae structure in the cardiac cycle as space constraint data; the spatially varying data and the spatially constrained data are aligned along a temporal sequence;
acquiring flow velocity and pressure data at a fluid inlet and a fluid outlet in the basic three-dimensional model as boundary data according to the hemodynamic characteristic data, and acquiring fluid unit parameters according to the hemodynamic characteristic data;
filling fluid units in the structure of the basic three-dimensional model, assigning the fluid unit parameters to the fluid units, and assigning initial structure parameters to the structure units of the basic three-dimensional model to form an initial three-dimensional model;
constructing a displacement load spectrum according to the space change data, and constructing a constraint spectrum according to the space constraint data;
performing initial assignment on a fluid inlet and outlet in the initial three-dimensional model, loading a central room structure and a ventricular structure of the initial three-dimensional model by taking the displacement load spectrum as a load, and simultaneously performing liquid-solid coupling dynamics calculation of the initial three-dimensional model by restricting displacement of an annular valve structure, a leaflet structure and a chordae tendineae structure by using the restriction spectrum;
If the fluid parameters of the fluid inlet and outlet in the initial three-dimensional model do not accord with the boundary data in the fluid-solid coupling dynamics calculation result, adjusting the assignment of the fluid unit and the structural unit and carrying out the fluid-solid coupling dynamics again until the fluid parameters of the fluid inlet and outlet in the initial three-dimensional model accord with the boundary data;
and if the fluid parameters of the fluid inlet and outlet in the initial three-dimensional model accord with the boundary data in the liquid-solid coupling dynamics calculation result, taking the initial three-dimensional model subjected to liquid-solid coupling dynamics calculation as the preoperative three-dimensional model.
When the embodiment of the application is implemented, in order to simulate the hydrodynamic force of the heart, a basic three-dimensional model of diastole needs to be built first, and then fluid in an atrium and a ventricle is loaded through the inner diameter change data of the atrium structure and the ventricle structure in one cardiac cycle to realize fluid operation. Because the annuloplasty ring structure, the leaflet structure and the chordae tendineae structure are all passive movements in the embodiment of the application, the displacement conditions of the structures are also required to be restrained by space restraint data so as to realize accurate simulation of the fluid movement state. It should be understood that in the above-mentioned basic three-dimensional model, the left and right atrial-ventricular structures need to be modeled, and the same annuli, valve leaflets and chords need to be modeled in the left and right atrial-ventricles, so that the units and spaces for corresponding modification of the surgical scheme can be reserved during modeling.
In the embodiments of the present application, the spatial variation data corresponding to the left and right atria and the left and right ventricles in one cardiac cycle should be relatively independent, which mainly shows the variation of the internal spaces of the left and right atria and the left and right ventricles, and the annuli, the valve leaflets and the chordae tendineae corresponding to the spatial constraint data should also be relatively independent, which mainly shows the specific situations of the passively operated annuli, valve leaflets and chordae tendineae in the atrial-ventricular systolic and diastolic processes.
In the embodiment of the present application, in order to ensure the accuracy of the simulation result, it is necessary to extract boundary data for performing related parameter correction of the subsequent model, and obtain fluid unit parameters, such as data of density, initial pressure, viscosity, and the like, from the hemodynamic characteristic data. The subsequent calculation is facilitated by filling the fluid cells inside the structure of the basic three-dimensional model as fluid to the inside of the basic three-dimensional model. For example, the construction of the basic three-dimensional model is performed by adopting ansys finite element model software, and the construction of the fluid unit is performed by using a fluid module fluent of ansys to perform liquid-solid coupling operation. The displacement load spectrum is constructed according to the spatial variation data, which is needed to represent the inner cavity variation of the atrium and the ventricle in one cardiac cycle, and the same constraint spectrum is constructed according to the spatial constraint data, which is used to represent the displacement and deformation constraint of the valve annulus, the valve leaflet and the chordae tendineae in one cardiac cycle.
In the embodiment of the application, the fluid inlet and outlet in the initial three-dimensional model needs to be initially assigned, real-time change of the data of the fluid inlet and outlet is detected in operation, if the real-time change accords with boundary data acquired by hemodynamic characteristic data, the model operation is proved to accord with requirements, and the model can be used as a preoperative three-dimensional model; if the boundary data is not met, parameters of the fluid unit and the structural unit are adjusted and recalculated until the boundary data is met, the fluid dynamics of the heart can be effectively simulated in the mode, and meanwhile, the dynamic simulation can be conducted closer to the actual situation due to the fact that the model calculation power in the embodiment of the application comes from the ventricular and atrial changes.
In a possible implementation, the modification unit is further configured to:
and adjusting the attribute and parameters of the unit at the corresponding part in the preoperative three-dimensional model according to the surgical scheme to form the postoperative three-dimensional model.
In one possible implementation, the arithmetic unit is further configured to:
and adjusting the constraint spectrum according to an operation scheme, loading the central room structure and the ventricular structure of the three-dimensional postoperative model by taking the displacement load spectrum as a load, and carrying out liquid-solid coupling dynamics calculation of the three-dimensional postoperative model by using the adjusted displacement of the constraint spectrum to constrain the valve annulus structure, the valve leaflet structure and the chordae tendineae structure.
When the embodiment of the application is implemented, the constraint spectrum and the structure of the preoperative three-dimensional model are required to be adjusted according to the operation scheme so as to facilitate the postoperative hydrodynamic calculation.
In one possible implementation, the arithmetic unit is further configured to:
obtaining a liquid-solid coupling dynamics calculation result of the postoperative three-dimensional model, and extracting fluid data and/or displacement deformation data of a corresponding key part from the result as the characteristic data;
when the characteristic data exceeds a preset value, judging that the corresponding operation scheme is unqualified;
and when the characteristic data does not exceed a preset value, judging that the corresponding operation scheme is qualified.
When the embodiment of the application is implemented, the obtained characteristic data can be used for judging whether the operation scheme is qualified or not, and the characteristic data are generally reflected in valve opening and closing conditions under the hemodynamic characteristics of the filling of each atrial ventricular cavity and under the physiological condition and fluid distribution conditions around the valve. Based on this data, a comparison can be made with preset values to quantify the rationality characterizing the surgical procedure.
On the basis of the foregoing, please refer to fig. 2 in combination, which is a schematic flow chart of a method for preoperative exercise of heart valve repair surgery according to an embodiment of the present invention, the method for preoperative exercise of heart valve repair surgery may be applied to a system for preoperative exercise of heart valve repair surgery in fig. 1, and further, the method for preoperative exercise of heart valve repair surgery may specifically include the following steps S1-S4.
S1: performing 3D ultrasonic detection on a target heart to obtain scanning data, and performing hemodynamic detection on the target heart to obtain hemodynamic characteristic data;
s2: constructing a preoperative three-dimensional model according to the scanning data and the hemodynamic characteristic data;
s3: modifying the preoperative three-dimensional model according to an operation scheme to form a postoperative three-dimensional model;
s4: calculating the postoperative three-dimensional model to obtain characteristic data of key parts in the postoperative three-dimensional model, and evaluating the operation scheme according to the characteristic data.
In one possible implementation, constructing a pre-operative three-dimensional model from the scan data and the hemodynamic characterization data includes:
constructing an atrial structure, a ventricular structure, an annular structure, a leaflet structure and a chordae tendineae structure in diastole according to the scanning data to form a basic three-dimensional model;
acquiring inner diameter change data of an atrial structure and a ventricular structure in a cardiac cycle from the scan data as space change data, and acquiring position and size change data of an annular structure, a leaflet structure and a chorda tendineae structure in the cardiac cycle as space constraint data; the spatially varying data and the spatially constrained data are aligned along a temporal sequence;
Acquiring flow velocity and pressure data at a fluid inlet and a fluid outlet in the basic three-dimensional model as boundary data according to the hemodynamic characteristic data, and acquiring fluid unit parameters according to the hemodynamic characteristic data;
filling fluid units in the structure of the basic three-dimensional model, assigning the fluid unit parameters to the fluid units, and assigning initial structure parameters to the structure units of the basic three-dimensional model to form an initial three-dimensional model;
constructing a displacement load spectrum according to the space change data, and constructing a constraint spectrum according to the space constraint data;
performing initial assignment on a fluid inlet and outlet in the initial three-dimensional model, loading a central room structure and a ventricular structure of the initial three-dimensional model by taking the displacement load spectrum as a load, and simultaneously performing liquid-solid coupling dynamics calculation of the initial three-dimensional model by restricting displacement of an annular valve structure, a leaflet structure and a chordae tendineae structure by using the restriction spectrum;
if the fluid parameters of the fluid inlet and outlet in the initial three-dimensional model do not accord with the boundary data in the fluid-solid coupling dynamics calculation result, adjusting the assignment of the fluid unit and the structural unit and carrying out the fluid-solid coupling dynamics again until the fluid parameters of the fluid inlet and outlet in the initial three-dimensional model accord with the boundary data;
And if the fluid parameters of the fluid inlet and outlet in the initial three-dimensional model accord with the boundary data in the liquid-solid coupling dynamics calculation result, taking the initial three-dimensional model subjected to liquid-solid coupling dynamics calculation as the preoperative three-dimensional model.
In one possible implementation, modifying the preoperative three-dimensional model according to a surgical scheme to form a post-operative three-dimensional model includes:
and adjusting the attribute and parameters of the unit at the corresponding part in the preoperative three-dimensional model according to the surgical scheme to form the postoperative three-dimensional model.
In one possible implementation, calculating the post-operative three-dimensional model includes:
and adjusting the constraint spectrum according to an operation scheme, loading the central room structure and the ventricular structure of the three-dimensional postoperative model by taking the displacement load spectrum as a load, and carrying out liquid-solid coupling dynamics calculation of the three-dimensional postoperative model by using the adjusted displacement of the constraint spectrum to constrain the valve annulus structure, the valve leaflet structure and the chordae tendineae structure.
In one possible implementation, obtaining the feature data of the key part in the three-dimensional postoperative model, and evaluating the surgical scheme according to the feature data includes:
Acquiring a liquid-solid coupling dynamics calculation result of the postoperative three-dimensional model, and extracting fluid data of a corresponding key part from the result as the characteristic data;
when the characteristic data exceeds a preset value, judging that the corresponding operation scheme is unqualified;
and when the characteristic data does not exceed a preset value, judging that the corresponding operation scheme is qualified.
Those of ordinary skill in the art will appreciate that the elements and algorithm steps described in connection with the embodiments disclosed herein may be embodied in electronic hardware, in computer software, or in a combination of the two, and that the elements and steps of the examples have been generally described in terms of function in the foregoing description to clearly illustrate the interchangeability of hardware and software. Whether such functionality is implemented as hardware or software depends upon the particular application and design constraints imposed on the solution. Skilled artisans may implement the described functionality in varying ways for each particular application, but such implementation decisions should not be interpreted as causing a departure from the scope of the present invention.
In the several embodiments provided in this application, it should be understood that the disclosed apparatus and method may be implemented in other ways. For example, the apparatus embodiments described above are merely illustrative, e.g., the division of the units is merely a logical function division, and there may be additional divisions when actually implemented, e.g., multiple units or components may be combined or integrated into another system, or some features may be omitted or not performed. In addition, the coupling or direct coupling or communication connection shown or discussed with each other may be an indirect coupling or communication connection via some interfaces, devices, or elements, or may be an electrical, mechanical, or other form of connection.
The elements described as separate components may or may not be physically separate, and it will be apparent to those skilled in the art that elements and algorithm steps of the examples described in connection with the embodiments disclosed herein may be implemented as electronic hardware, computer software, or combinations of both, and that the elements and steps of the examples have been generally described functionally in the foregoing description so as to clearly illustrate the interchangeability of hardware and software. Whether such functionality is implemented as hardware or software depends upon the particular application and design constraints imposed on the solution. Skilled artisans may implement the described functionality in varying ways for each particular application, but such implementation decisions should not be interpreted as causing a departure from the scope of the present invention.
In addition, each functional unit in the embodiments of the present invention may be integrated in one processing unit, or each unit may exist alone physically, or two or more units may be integrated in one unit. The integrated units may be implemented in hardware or in software functional units.
The integrated units, if implemented in the form of software functional units and sold or used as stand-alone products, may be stored in a computer readable storage medium. Based on such understanding, the technical solution of the present invention is essentially or a part contributing to the prior art, or all or part of the technical solution may be embodied in the form of a software product stored in a storage medium, comprising several instructions for causing a computer device (which may be a personal computer, a server, a grid device, etc.) to perform all or part of the steps of the method according to the embodiments of the present invention. And the aforementioned storage medium includes: a U-disk, a removable hard disk, a Read-Only Memory (ROM), a random access Memory (RAM, randomAccess Memory), a magnetic disk, or an optical disk, or other various media capable of storing program codes.
The foregoing description of the embodiments has been provided for the purpose of illustrating the general principles of the invention, and is not meant to limit the scope of the invention, but to limit the invention to the particular embodiments, and any modifications, equivalents, improvements, etc. that fall within the spirit and principles of the invention are intended to be included within the scope of the invention.
Claims (9)
1. A system for preoperative exercise of heart surgical valve repair surgery, comprising:
the acquisition unit is configured to perform 3D ultrasonic detection on a target heart to obtain scanning data, and perform hemodynamic detection on the target heart to obtain hemodynamic characteristic data;
a modeling unit configured to construct a preoperative three-dimensional model from the scan data and the hemodynamic characteristic data;
a modification unit configured to modify the preoperative three-dimensional model according to a surgical scheme to form a post-operative three-dimensional model;
the calculation unit is configured to calculate the postoperative three-dimensional model to obtain the characteristic data of the key part in the postoperative three-dimensional model, and evaluate the surgical scheme according to the characteristic data;
the modeling unit is further configured to:
constructing an atrial structure, a ventricular structure, an annular structure, a leaflet structure and a chordae tendineae structure in diastole according to the scanning data to form a basic three-dimensional model;
acquiring inner diameter change data of an atrial structure and a ventricular structure in a cardiac cycle from the scan data as space change data, and acquiring position and size change data of an annular structure, a leaflet structure and a chorda tendineae structure in the cardiac cycle as space constraint data; the spatially varying data and the spatially constrained data are aligned along a temporal sequence;
Acquiring flow velocity and pressure data at a fluid inlet and a fluid outlet in the basic three-dimensional model as boundary data according to the hemodynamic characteristic data, and acquiring fluid unit parameters according to the hemodynamic characteristic data;
filling fluid units in the structure of the basic three-dimensional model, assigning the fluid unit parameters to the fluid units, and assigning initial structure parameters to the structure units of the basic three-dimensional model to form an initial three-dimensional model;
constructing a displacement load spectrum according to the space change data, and constructing a constraint spectrum according to the space constraint data;
performing initial assignment on a fluid inlet and outlet in the initial three-dimensional model, loading a central room structure and a ventricular structure of the initial three-dimensional model by taking the displacement load spectrum as a load, and simultaneously performing liquid-solid coupling dynamics calculation of the initial three-dimensional model by restricting displacement of an annular valve structure, a leaflet structure and a chordae tendineae structure by using the restriction spectrum;
if the fluid parameters of the fluid inlet and outlet in the initial three-dimensional model do not accord with the boundary data in the fluid-solid coupling dynamics calculation result, adjusting the assignment of the fluid unit and the structural unit and carrying out the fluid-solid coupling dynamics again until the fluid parameters of the fluid inlet and outlet in the initial three-dimensional model accord with the boundary data;
And if the fluid parameters of the fluid inlet and outlet in the initial three-dimensional model accord with the boundary data in the liquid-solid coupling dynamics calculation result, taking the initial three-dimensional model subjected to liquid-solid coupling dynamics calculation as the preoperative three-dimensional model.
2. The system for preoperative drilling of a heart surgical valve repair procedure of claim 1, wherein the modification unit is further configured to:
and adjusting the attribute and parameters of the unit at the corresponding part in the preoperative three-dimensional model according to the surgical scheme to form the postoperative three-dimensional model.
3. The system for preoperative exercise of heart surgical valve repair surgery of claim 1, wherein the computing unit is further configured to:
and adjusting the constraint spectrum according to an operation scheme, loading the central room structure and the ventricular structure of the three-dimensional postoperative model by taking the displacement load spectrum as a load, and carrying out liquid-solid coupling dynamics calculation of the three-dimensional postoperative model by using the adjusted displacement of the constraint spectrum to constrain the valve annulus structure, the valve leaflet structure and the chordae tendineae structure.
4. The system for pre-operative drilling of a heart surgical valve repair procedure of claim 3, wherein the computing unit is further configured to:
Obtaining a liquid-solid coupling dynamics calculation result of the postoperative three-dimensional model, and extracting fluid data and/or displacement deformation data of a corresponding key part from the result as the characteristic data;
when the characteristic data exceeds a preset value, judging that the corresponding operation scheme is unqualified;
and when the characteristic data does not exceed a preset value, judging that the corresponding operation scheme is qualified.
5. A method for preoperative exercise of heart surgical valve repair surgery using the system of any one of claims 1-4, comprising:
performing 3D ultrasonic detection on a target heart to obtain scanning data, and performing hemodynamic detection on the target heart to obtain hemodynamic characteristic data;
constructing a preoperative three-dimensional model according to the scanning data and the hemodynamic characteristic data;
modifying the preoperative three-dimensional model according to an operation scheme to form a postoperative three-dimensional model;
calculating the postoperative three-dimensional model to obtain characteristic data of key parts in the postoperative three-dimensional model, and evaluating the operation scheme according to the characteristic data.
6. The method for pre-operative drilling of a heart surgical valve repair procedure of claim 5, wherein constructing a pre-operative three-dimensional model from the scan data and the hemodynamic characterization data comprises:
Constructing an atrial structure, a ventricular structure, an annular structure, a leaflet structure and a chordae tendineae structure in diastole according to the scanning data to form a basic three-dimensional model;
acquiring inner diameter change data of an atrial structure and a ventricular structure in a cardiac cycle from the scan data as space change data, and acquiring position and size change data of an annular structure, a leaflet structure and a chorda tendineae structure in the cardiac cycle as space constraint data; the spatially varying data and the spatially constrained data are aligned along a temporal sequence;
acquiring flow velocity and pressure data at a fluid inlet and a fluid outlet in the basic three-dimensional model as boundary data according to the hemodynamic characteristic data, and acquiring fluid unit parameters according to the hemodynamic characteristic data;
filling fluid units in the structure of the basic three-dimensional model, assigning the fluid unit parameters to the fluid units, and assigning initial structure parameters to the structure units of the basic three-dimensional model to form an initial three-dimensional model;
constructing a displacement load spectrum according to the space change data, and constructing a constraint spectrum according to the space constraint data;
performing initial assignment on a fluid inlet and outlet in the initial three-dimensional model, loading a central room structure and a ventricular structure of the initial three-dimensional model by taking the displacement load spectrum as a load, and simultaneously performing liquid-solid coupling dynamics calculation of the initial three-dimensional model by restricting displacement of an annular valve structure, a leaflet structure and a chordae tendineae structure by using the restriction spectrum;
If the fluid parameters of the fluid inlet and outlet in the initial three-dimensional model do not accord with the boundary data in the fluid-solid coupling dynamics calculation result, adjusting the assignment of the fluid unit and the structural unit and carrying out the fluid-solid coupling dynamics again until the fluid parameters of the fluid inlet and outlet in the initial three-dimensional model accord with the boundary data;
and if the fluid parameters of the fluid inlet and outlet in the initial three-dimensional model accord with the boundary data in the liquid-solid coupling dynamics calculation result, taking the initial three-dimensional model subjected to liquid-solid coupling dynamics calculation as the preoperative three-dimensional model.
7. The method for preoperative drilling of a heart surgical valve repair procedure of claim 6, wherein modifying the preoperative three-dimensional model according to a surgical plan to form a post-operative three-dimensional model comprises:
and adjusting the attribute and parameters of the unit at the corresponding part in the preoperative three-dimensional model according to the surgical scheme to form the postoperative three-dimensional model.
8. The method for preoperative exercise of heart surgical valve repair surgery of claim 6, wherein calculating the post-operative three-dimensional model comprises:
And adjusting the constraint spectrum according to an operation scheme, loading the central room structure and the ventricular structure of the three-dimensional postoperative model by taking the displacement load spectrum as a load, and carrying out liquid-solid coupling dynamics calculation of the three-dimensional postoperative model by using the adjusted displacement of the constraint spectrum to constrain the valve annulus structure, the valve leaflet structure and the chordae tendineae structure.
9. The method for preoperative drilling of a heart surgical valve repair procedure of claim 8, wherein obtaining feature data for key locations in the post-operative three-dimensional model and evaluating the procedure plan based on the feature data comprises:
obtaining a liquid-solid coupling dynamics calculation result of the postoperative three-dimensional model, and extracting fluid data and/or displacement deformation data of a corresponding key part from the result as the characteristic data;
when the characteristic data exceeds a preset value, judging that the corresponding operation scheme is unqualified;
and when the characteristic data does not exceed a preset value, judging that the corresponding operation scheme is qualified.
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