Patient-Specific Coronary Stenoses Can Be Modeled Using a Combination of OCT and Flow Velocities to Accurately Predict Hyperemic Pressure Gradients

被引：14

作者：

Kousera, C. A. ^{[1
]}

Nijjer, S. ^{[1
]}

Torii, R. ^{[2
]}

Petraco, R. ^{[1
]}

Sen, S. ^{[1
]}

Foin, N. ^{[1
]}

Hughes, A. D. ^{[1
]}

Francis, D. P. P. ^{[1
]}

Xu, X. Y. ^{[3
]}

Davies, J. E. ^{[1
]}

机构：

[1] Univ London Imperial Coll Sci Technol & Med, Int Ctr Circulatory Hlth, London SW7 2AZ, England

[2] UCL, Dept Mech Engn, London WC1E 6BT, England

[3] Univ London Imperial Coll Sci Technol & Med, Dept Chem Engn, London SW7 2AZ, England

来源：

IEEE TRANSACTIONS ON BIOMEDICAL ENGINEERING | 2014年 / 61卷 / 06期

基金：

英国医学研究理事会;

关键词：

Angiographic imaging; coronary arteries; finite-element modeling; optical coherence tomography (OCT); COMPUTATIONAL FLUID-DYNAMICS; BLOOD-FLOW; WALL SHEAR; ANGIOGRAPHY; ARTERY; RECONSTRUCTION; RESERVE; VALIDATION; CAAS; SEVERITY;

D O I：

10.1109/TBME.2014.2310954

中图分类号：

R318 [生物医学工程];

学科分类号：

0831 ;

摘要：

Computational fluid dynamics (CFD) is increasingly being developed for the diagnostics of arterial diseases. Imaging methods such as computed tomography (CT) and angiography are commonly used. However, these have limited spatial resolution and are subject to movement artifact. This study developed a new approach to generate CFD models by combining high-fidelity, patient-specific coronary anatomy models derived from optical coherence tomography (OCT) imaging with patient-specific pressure and velocity phasic data. Additionally, we used a new technique which does not require the catheter to be used to determine the centerline of the vessel. The CFD data were then compared with invasively measured pressure and velocity. Angiography imaging data of 21 vessels collected from 19 patients were fused with OCT visualizations of the same vessels using an algorithm that produces reconstructions inheriting the in-plane (10 mu m) and longitudinal (0.2 mm) resolution of OCT. Proximal pressure and distal velocity waveforms ensemble averaged from invasively measured data were used as inlet and outlet boundary conditions, respectively, in CFD simulations. The resulting distal pressure waveform was compared against the measured waveform to test the model. The results followed the shape of the measured waveforms closely (cross-correlation coefficient = 0.898 +/- 0.005, p < 0.01), indicating realistic modeling of flow resistance, the mean of differences between measured and simulated results was -3.5 mmHg, standard deviation of differences (SDD) = 8.2 mmHg over the cycle and -9.8 mmHg, SDD = 16.4 mmHg at peak flow. Models incorporating phasic velocity in patient-specific models of coronary anatomy derived from high-resolution OCT images show a good correlation with the measured pressure waveforms in all cases, indicating that the model results may be an accurate representation of the measured flow conditions.

引用

页码：1902 / 1913

页数：12

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