基于三维重建方法的颈动脉狭窄手术仿真研究

目的:基于三维重建方法模拟颈动脉狭窄手术治疗,为颈动脉狭窄的治疗提供有力支持。方法:选取颈动脉狭窄CT血管造影(CT angiography,CTA)图像,使用Mimics、Geomagic和Solidworks软件进行处理,重建患者颈动脉狭窄分支模型,再对模型进行修正和编辑,模拟去狭窄手术治疗,建立狭窄消除模型,并进行有限元计算。结果:重建的右侧颈总动脉分支模型中颈内动脉重度狭窄,颈外动脉中度狭窄,与临床诊断结果一致。有限元计算结果显示,颈外动脉狭窄消除后,原狭窄处血流速度下降,但是颈外动脉出口血流速度变化不大,颈外动脉和颈内动脉涡流有所改善;颈外动脉壁面切应力降低,降至20~30 Pa。结论:对于颈外动脉中度狭窄,去狭窄治疗可以改善血流灌注情况,可以根据患者具体情况采取治疗手段。

Simulation study of carotid artery stenosis surgery based on 3D reconstruction

Objective To explore 3D reconstruction-based simulation of the carotid artery stenosis surgery to facilitate the treatment of carotid artery stenosis.Methods CT angiography(CTA)images of carotid artery stenosis were selected and processed using Mimics,Geomagic and Solidworks software to reconstruct the branch models of the patients'carotid artery stenosis.The branch models were modified and edited to simulate destenosis surgery,then a stenosis elimination model was formed,and finite element calculation was executed.Results The reconstructed model of the right common carotid branch showed severe stenosis in the internal carotid artery and moderate stenosis in the external carotid artery,which were consistent with the clinical diagnosis.The finite element calculation proved that after the stenosis of the external carotid artery was eliminated,the flow velocity at the original stenosis decreased,while the flow velocity at the exit of the external carotid artery did not change significantly,and the vortexes of the external and internal carotid arteries improved;the wall shear stress of the external carotid artery decreased to 20-30 Pa.Conclusion For moderate stenosis of the external carotid artery,destenosis treatment can improve perfusion and can be tailored based on the patient's condition.Chinese Medical Equipment Journal,2021,42(2):27-30,36]