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Towards patient-specific modeling of mitral valve repair: 3D transesophageal echocardiography-derived parameter estimation.
走向患者特异性的二尖瓣修复术建模: 3D 经食管超声心动图导出的参数估计。
Finite element biomechanical model Mitral valve Mitral valve closure simulation Patient-specific model Transesophageal echocardiography
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摘要

Transesophageal echocardiography (TEE) is routinely used to provide important qualitative and quantitative information regarding mitral regurgitation. Contemporary planning of surgical mitral valve repair, however, still relies heavily upon subjective predictions based on experience and intuition. While patient-specific mitral valve modeling holds promise, its effectiveness is limited by assumptions that must be made about constitutive material properties. In this paper, we propose and develop a semi-automated framework that combines machine learning image analysis with geometrical and biomechanical models to build a patient-specific mitral valve representation that incorporates image-derived material properties. We use our computational framework, along with 3D TEE images of the open and closed mitral valve, to estimate values for chordae rest lengths and leaflet material properties. These parameters are initialized using generic values and optimized to match the visualized deformation of mitral valve geometry between the open and closed states. Optimization is achieved by minimizing the summed Euclidean distances between the estimated and image-derived closed mitral valve geometry. The spatially varying material parameters of the mitral leaflets are estimated using an extended Kalman filter to take advantage of the temporal information available from TEE. This semi-automated and patient-specific modeling framework was tested on 15 TEE image acquisitions from 14 patients. Simulated mitral valve closures yielded average errors (measured by point-to-point Euclidean distances) of 1.86 ± 1.24 mm. The estimated material parameters suggest that the anterior leaflet is stiffer than the posterior leaflet and that these properties vary between individuals, consistent with experimental observations described in the literature.

译文

经食管超声心动图 (TEE) 常规用于提供有关二尖瓣返流的重要定性和定量信息。然而,现代的手术二尖瓣修复术计划仍然很大程度上依赖于基于经验和直觉的主观预测。虽然患者特定的二尖瓣建模有希望,但其有效性受到必须对本构材料特性做出的假设的限制。在本文中, 我们提出并开发了一种半自动化框架,该框架将机器学习图像分析与几何和生物力学模型相结合,以构建包含图像衍生材料特性的患者特异性二尖瓣表示。我们使用我们的计算框架,以及开放和关闭的二尖瓣的 3D TEE 图像,来估计脊索休息长度和小叶材料属性的值。这些参数使用通用值初始化,并优化以匹配开放和关闭状态之间的二尖瓣几何形状的可视化变形。优化是通过最小化估计和图像导出的闭合二尖瓣几何之间的求和欧几里得距离来实现的。使用扩展卡尔曼滤波器利用 TEE 提供的时间信息来估计二尖瓣叶的空间变化材料参数。这种半自动和患者特定的建模框架在来自 14 名患者的 15 个 TEE 图像采集上进行了测试。模拟二尖瓣关闭产生的平均误差 (通过点对点欧氏距离测量) 为 1.86 ± 1.24毫米。估计的材料参数表明前叶比后叶更硬,这些特性在个体之间变化,与文献中描述的实验观察一致。

transesophageal echocardiography

心血管 影像 诊断方式
概述  :  

超声心动图一般均经胸壁检查,但因受胸骨、肋骨及肺组织的阻挡,影响图像的清晰度。经食管超声心动图(TEE)检查时,探头位于食管,由后向前近距探测深部心脏结构,开辟一新的窗口,能显示出清晰的图像,特别在肥胖、肺气肿或胸壁畸形患者胸前超声不能探及心脏时,经食管检查更有突出的效果,这些使得心脏疾患的诊断敏感性与特异性有很大提高。临床价值根据文献报道及华中科技大学同济医学院附属同济医院临床应用的体会,经食管二维多普勒彩色血流显像对下列疾病的诊断较之经胸超声检查有明显优点,具有特殊的诊断价值。(一)评价

Transesophageal

释义   经食道

例句   To evaluate the clinical value of Intraoperative transesophageal Echocardiography (TEE) in cardiac valve repair or replacement. 

评价术中经食管超声心动图(TEE)在心脏瓣膜成形、置换术中的临床价值。

 

Echocardiography ['ekəu,kɑ:di'ɔɡrəfi] 

释义   n. [内科] 超声波心动描记术;心回波描记术

例句   Therefore, their heart failure patient do not have echocardiography as frequently as we have thatin France or Germany. 

因此他们的患者不能像法国或德国的患者那样频繁的使用超声心动图。


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