Real-time model-based cerebral perfusion calculation for ischemic stroke
Real-time model-based cerebral perfusion calculation for ischemic stroke
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DOI：
10.1016/j.cmpb.2023.107916
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发表时间：
2023-11
影响因子：
6.1
通讯作者：
Hao Sun;Bao Li;Jincheng Liu;Xiaolu Xi;Liyuan Zhang;Yanping Zhang;Guangfei Li;Huamei Guo;Kenan Gu;Tongna Wang;Chuanqi Wen;Youjun Liu
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文献类型：
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作者：
Hao Sun;Bao Li;Jincheng Liu;Xiaolu Xi;Liyuan Zhang;Yanping Zhang;Guangfei Li;Huamei Guo;Kenan Gu;Tongna Wang;Chuanqi Wen;Youjun Liu
背景和目的缺血性脑卒中的临床诊断通常依赖于使用计算机断层扫描灌注（CTP）技术检测脑灌注变化。然而，在CTP的辐射剂量是相当高的比较，计算机断层扫描血管造影（CTA），与相关的成本和time.MethodsHence，本研究建立了一个集总参数模型（LPM）的脑组织微循环（BTM）的基础上CTA，旨在实现实时计算脑灌注。在用临床数据验证计算结果后，BTM-LPM模型被用于检查缺血性卒中后脑灌注的变化，其中考虑了Willis环（CoW）的9个解剖结构的影响以及供血动脉狭窄的各种分布模式。供血动脉的均方误差（MSE）值为3.9%，其在每个区域中的微循环流量的总值为0.1%。值得注意的是，计算时间为35.6 s。在CoW缺失左右后交通动脉的情况下，基底动脉60%的狭窄可能导致左右半球的一些颞叶和枕叶的缺血性损伤。而在CoW缺失前交通动脉和左后交通动脉的情况下，当左侧颈内动脉狭窄80%时，发现整个额叶和部分左半球颞叶和顶叶缺血性损害。本研究提出的LPM能够真实的实时准确地计算脑灌注，并证明了CoW解剖结构在不同脑组织缺血损伤中的重要性。计算的脑灌注值可作为脑组织缺血性损伤早期诊断和术前计划的参考值，有望取代CTP检查。
Background and ObjectivesClinical diagnosis of ischemic stroke commonly relies on examining cerebral perfusion changes by using computed tomography perfusion (CTP) techniques. However, the radiation dose in CTP is quite higher in comparison to computed tomography angiography (CTA), with associated costs and time.MethodsHence, this study established a lumped-parameter model (LPM) of brain tissue microcirculation (BTM) based on CTA, aiming to achieve real-time calculation of cerebral perfusion. After validation of calculated flow results with clinical data, the BTM-LPM model was used to examine the changes in cerebral perfusion following ischemic stroke, in which the effects of nine anatomical structures of the Circle of Willis (CoW) together with various distribution patterns of stenosis in the feeding arteries were considered.ResultsWhen compared the calculated flow results from BTM-LPM with the clinically measured data of literature, the mean squared error (MSE) value for the feeding arteries was 3.9 % and its total value for microcirculatory flow in each region was 0.1 %. Notably, the calculation time was 35.6 s. In the case of the CoW missing the left and right posterior communicating artery, a 60 % stenosis of the basilar artery is likely to cause ischemic damage to some temporal and occipital lobes of the right and left hemispheres. While in the case of the CoW missing the anterior communicating artery and the left posterior communicating artery, ischemic damage to the entire frontal lobe and parts of the temporal and parietal lobes of the left hemisphere was found when 80 % stenosis occurred in the left internal carotid artery.ConclusionsThe BTM-LPM proposed in this study could accurately calculate cerebral perfusion in real time and demonstrated the importance of CoW anatomy in different ischemic injuries to cerebral tissue. The calculated cerebral perfusion would be a reference value for early diagnosis and preoperative planning of different ischemic injuries to cerebral tissue, thereby the BTM-LPM holds great promising for replacing CTP examination.