Release date: 2015-07-07
The cardiac stent is the main method for the treatment of coronary artery stenosis, but under what circumstances is the stent placed? How many stents are placed? What is the most suitable position for the stent? There are no relevant standards for these problems, and more depends on the experience of doctors. Recently, physicists and medical scientists have collaborated to come up with a new approach - individualized cardiovascular 3D simulation technology. Scientists hope that this technology can help doctors to develop the best surgical plan to facilitate communication between doctors and patients. At the same time, combined with medical big data, the treatment can be more systematic and rigorous.
Analog computing and 3D printing to help personalize treatment
Liu Yuyu, a researcher at the Institute of Physics of the Chinese Academy of Sciences, is the principal of the study. He said: "The stent intervention often relies on the doctor's experience. The doctor will determine the surgical and surgical options based on anatomical features such as plaque distribution, bifurcation angle, and vessel diameter of the coronary artery." However, individual differences in patients It is relatively large, so sometimes the experience is not reliable. "Because of the choice of stent and stent placement, the situation of restenosis after surgery often occurs, and the patient needs surgery."
So, is there a way to combine experience with individual patient conditions to achieve precision medicine?
Based on the medical image data of clinical cases, Liu Yuyu team and the team of chief physicians of Liu Jinghua of Anzhen Hospital reconstructed the real blood vessel shape of the patient through medical image processing method, and virtualized four kinds of methods based on the advice of clinicians. The surgical procedures with different stent placement positions were performed and computer fluid dynamics simulation calculations were performed.
Liu Yuyu said: "In short, the blood flows in the blood vessels, the blood is not enough, the pressure on the blood vessel wall is large, is it dangerous, and there will be problems such as narrowing in the follow-up, from a physics point of view It's all about fluid mechanics. So we designed several calculation programs, and after taking some data from the patient, we can construct a three-dimensional image of the cardiovascular, and then whether the patient needs the stent, and further calculate the stent. How many and where to put them."
In order to verify the accuracy of the simulation, the researchers used 3D printing technology and microfluidic chip processing technology to successfully manufacture a blood vessel model with a true three-dimensional structure, and used the model to implement a fluid experiment. The measurement results show that the difference from the computer simulation results is only about 10%. Liu Yuyu said: "This shows that the fluid dynamics simulation results we designed are reliable."
Will develop convenient APP application service in the future
Liu Yuyu said that the application development of the team's future research is an APP program that can be applied on smart mobile terminals such as smart phones. Dr. Rong Xiaohui, one of the team members of the Institute of Physics of the Chinese Academy of Sciences, described the app as follows: “After performing an instrument examination in the hospital and obtaining medical image data, the patient can first upload the personal image data to the cloud through a dedicated APP. After that, the engineer will According to the image type and quality, the algorithm is selected and adjusted to obtain the three-dimensional reconstructed blood vessel model. In our design, this model can be freely rotated, enlarged, measured, and can give doctors and patients the most visual and intuitive understanding, while patients can Use this basic app and service for free."
Next, the engineer will use computer-aided design to simulate several possible surgical plans based on doctor's advice, and use computer physical modeling calculations to obtain analysis of flow fields, force distributions, and specific clinical indicators, and feedback on all calculations. Give the doctor. After the doctors get these calculations, the best surgical plan will be determined based on clinical knowledge and experience, and then the popularized diagnosis results and the recommended surgical plan will be fed back to the patient.
"This is not our ultimate goal." Liu Yuyu said, "Next we hope to cooperate with more clinicians to establish a large database of cases." He explained that patients vary widely, "the specific surgical plan is not only The choice of stents is related to placement. It may also be related to many factors such as lifestyle, constitution, history, personality, etc., but these data should be supported by enough clinical cases. "We will carry out the system based on these data. Rigorous clinical comparisons and medical statistics, and ultimately determine a reliable technical solution."
Source: Guangming Daily
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