Image of Congenital Heart Disease：Computed Tomography, Mathematical Analysis of Development and Biomodeling
Date Issued
2006
Date
2006
Author(s)
DOI
zh-TW
Abstract
The incidence of the congenital heart disease in Taiwan is higher than that was reported in the world. And, the congenital heart disease is the highest occurrence of congenital deformity of live birth in our country. Thereafter, the importance of the congenital heart disease in Taiwan is straightforward. However in these patients, owing to differences of age, disease entity, associated anomalies, severity.. etc, there are no two patients have the exactly same condition. So, individualization both on diagnosis and treatment become very important.
In diagnosis, comprehensive information should be got before any intervention or disposition. Advanced computed tomography becomes an essential imaging tool in the diagnosis of the congenital heart disease by providing key evidence for decision making because it has the following advantages: highest spatial resolution in sectional imaging modalities, no limitation in the field of be examined, complete the study in very short time, non-invasiveness, simple procedure by lying of the patient on the examination table. Basically computed tomography can well delineate the internal structures of the disease heart. Computed tomography is superior to other imaging modalities in demonstration of the pulmonary vein, pulmonary artery, coronary artery and the complex geometry of the heart. Structures outside of the heart also can be well shown by computed tomography; they are trachea, lung, and mediastinum and chest wall. This character let the computed tomography to be a single modality that can overcome many fields of exploring that is hardly be achieved by other imaging modalities.
Accompany with the rapid developing of the software and hardware in computer science, reconstruction of the raw data from the volume acquition by computed tomography scanner has great achievement. Using this three-dimensional reconstruction on the cases with congenital heart disease, patients, families and medical practices all could see the diseased heart in global and just like the real object on images. By providing the virtual reality, we also can perceive the image that cannot be identify in life. In this thesis, many algorithms that can get different effect on image reconstruction is demonstrated and discussed. However, it takes a lot of time for a specialist to manually manipulate these raw data in order to make this reconstruction. In the further, if we can set up a comprehensive electronic database of each types of the congenital heart disease and get a lot of averaged models, we will have the opportunity to make a semi-automatic algorithm in images reconstruction. At that time, the widespread apply of the three-dimensional reconstruction in the congenital heart disease will be feasible.
These numerical electronic hearts will be the basic component of the electronic database. More important, these numerical cardiac models will be the platform for quantitative simulation in both calculation and statistics. Owing to the rapid development of the genomic and proteomics, the knowledge on basic medicine is quickly accumulated. However, at present there is no comprehensive interface for bridge this basic biomedical knowledge (genotype) to diverse clinical presentations (phenotype). In case of the shape of the congenital heart disease, there are only limited phenotypes (disease entities: such as transposition of the great arteries, tetralogy of Fallot … etc) that can be used to correlate to the genotype. However, there maybe a possibility that some particular one gene may control the development of the aortic arch, thereafter this gene should have impact on the final shape of the aortic arch in all kinds of the congenital heart disease. If researcher only takes one specific diseased heart into consideration and focus on this particular gene, then the correlation maybe not strong enough to get attention. On the other hand, if we could collection the electronic numerical shape of the aortic arch of any types congenital heart disease, maybe we can use data mining and analysis strategy to integrate from the genomic, developmental embryology to the clinical manifestation. Such strategy may fasten disclose the function of many genes of unknown function. This study demonstrates the preliminary application of this strategy to analyze the possible development embryology of the systemic venous return of the left upper body by using the numerical cardiovascular information.
Individualized intervention in each patient with the congenital heart disease is the final practical purpose of the research and explore on this topic. Because of the wide variation of the involvement of each component in the congenital heart disease, individualized intervention on each patient is the best policy of the disposition particularly on those patients with the complex congenital heart disease. Additionally, cardiovascular surgery usually has only limited time of revision to prevent unnecessary injury let the pre-operative planning and simulation is extremely important. By way of stereolithography, this report has build up a systemic protocol and a reasonable procedure to replicate a living heart model. This model provides a solid presentation of exactly the same of the patients’ heart for diagnosis, discussion and interpretation. Moreover, surgeon can repeat and repeat practice on this model before really put the patient on the operative table and perform such surgical procedures. This model also can provide a real size template for cutting any augmented patch. The preliminary result on the application of this cardiac model revealed the improvement of the confidence both on surgical manipulation and patient education.
In conclusion, the present thesis reports the integrate research on the imaging application of the congenital heart disease step by step, it first made by the development of the diagnostic tool, then continue by the wide range of the application of this tool, and finally extends to the verification of this tool. These results try to satisfy the need of each individual with different congenital heart disease to improve the quality of their life.
Subjects
先天性心臟病影像
電腦斷層掃描攝影
數值發育分析
生物模型
Image of Congenital Heart Disease
Computed Tomography
Mathematical Analysis of Development
Biomodeling
Type
text
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