Leveraging Patient-Specific Simulated Angiograms to Characterize Cerebral Aneurysm Hemodynamics using Computational Fluid Dynamics.
Leveraging Patient-Specific Simulated Angiograms to Characterize Cerebral Aneurysm Hemodynamics using Computational Fluid Dynamics.
复制标题
利用计算流体动力学，利用特定于患者的模拟血管造影来表征脑动脉瘤血流动力学。
DOI：
10.1117/12.2611473
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发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Ionita,C
中科院分区：
文献类型：
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作者：
Chivukula,V;White,R;Shields,A;Davies,J;Mokin,M;Bednarek,DR;Rudin,S;Ionita,C
脑动脉瘤（CA）影响了近6%的美国人口，其破裂是出血性中风的主要原因之一。进行血管内治疗（ET）治疗CA的神经介入医师仅依赖于在透视引导下获得的定性图像序列，无法获得治疗前、治疗中和治疗后血流的关键定量信息——部分导致失败率高达30%。计算流体动力学（CFD）是一个强大的工具，可以提供丰富的定量数据；然而，由于难以获得每位患者的血流动力学边界条件，CFD在临床中的应用有限。在这项工作中，我们提出了一种新的基于cfd的模拟血管造影方法（SAA），该方法解决了血流物理和血液与注射造影剂之间的相互作用，以提取定量血流动力学参数，这些参数可用于设计实时参数化成像分析。SAA可以通过在感兴趣区域的几个点获得的时间密度曲线（TDC）将造影剂运输与潜在的血流动力学条件相关联。探讨并介绍了TDC和SAA提供CA解剖内及周围关键血流动力学参数的能力，如冲洗和局部血流变化。这为临床医生在干预时提供了宝贵的定量数据，因为它结合了血流的物理特性，并定量地将造影剂运输与血流动力学参数联系起来，从而使临床医生能够做出明智的决定，从而改善治疗结果。
Cerebral aneurysms (CA) affect nearly 6% of the US population and its rupture is one of the major causes of hemorrhagic stroke. Neurointerventionalists performing endovascular therapy (ET) to treat CA rely on qualitative image sequences obtained under fluoroscopy guidance alone, and do not have access to crucial quantitative information regarding blood flow before, during and after treatment – partially contributing to a failure rate of up to 30%. Computational fluid dynamics (CFD) is a powerful tool that can provide a wealth of quantitative data; however, CFD has found limited utility in the clinic due to the challenges in obtaining hemodynamic boundary conditions for each patient. In this work, we present a novel CFD-based simulated angiogram approach (SAA) that resolves the blood flow physics and interaction between blood and injected contrast agent to extract quantitative hemodynamic parameters which can be used to design real-time parametric imaging analysis. The SAA enables correlating contrast agent transport to the underlying hemodynamic conditions via time-density curves (TDC) obtained at several points in the region of interest. The ability of the TDC and the SAA to provide critical hemodynamic parameters in and around CA anatomies, such as washout and local flow changes is explored and presented. This provides invaluable quantitative data to the clinician at the time of intervention, since it incorporates the physics of blood flow and correlates the contrast transport to hemodynamic parameters quantitatively – thereby enabling the clinician to take informed decisions that improve treatment outcomes.