Method for assessing distal tear progression in aortic dissection based on morphological changes
Patent Information
- Application Number
- CN202410432057.2
- Authority / Receiving Office
- CN · China
- Patent Type
- Applications(China)
- Current Assignee / Owner
- Filing Date
- 2024-04-11
- Publication Date
- 2026-10-27
AI Technical Summary
这使得医生在临床难以把握该种病变的长期发展趋势与恶化情况，也没有进行及时临床干预可以参考的依据
[0026]本发明的有益效果为：首先，本专利中所展示的形态学分析方法目前并未被相关研究所提及的，用以描述主动脉夹层远端撕裂的形态特征。其次，这些参数的获取可以完全基于医学影像信息，不需要临床增加测量成本，主要是对临床采集图像信息的再加工，不会增加患者负担。另外，这些形态学参数的测定过程属于无创的，不会对病人身体造成任何影响。最后，这些形态学参数从另一角度描述了夹层远端形态特征，更加关注夹层远端撕裂的随访改变，以监控夹层假腔的局部形态变化情况，为医生临床提供有价值的参考。
Smart Images
Figure CN122991423A_ABST
Abstract
Description
Technical Field
[0001] This invention belongs to the field of assessment of distal aortic dissection, specifically relating to a method for assessing the development of distal aortic dissection based on morphological changes. Background Technology
[0002] Aortic dissection (AD) is a serious cardiovascular emergency caused by blood entering the aortic wall through a proximal tear in the aortic intima, resulting in separation of the arterial wall and the formation of a true and false lumen, as well as distal secondary intimal tears. It has a high mortality rate. The location of the distal tear in aortic dissection varies significantly among patients. In some patients, the tear is confined to the thoracic aorta, while in severe cases, it involves the abdominal aorta and its branches, even extending to the iliac arteries. However, there is currently no quantitative method to describe the development and progression of distal aortic tears, and clinical intervention guidelines for this condition have not been established. This makes it difficult for clinicians to grasp the long-term progression and deterioration of the disease, and there is a lack of reliable guidelines for timely clinical intervention. Summary of the Invention
[0003] To overcome the shortcomings of existing technologies, this invention provides a method for assessing the development of distal aortic dissection based on morphological changes. Considering the possibility of further downward tearing at the distal end of the dissection, affecting a larger area of the aorta and its branches, we study the relevant morphological characteristics of distal tears in aortic dissection patients and use different morphological parameters to quantitatively describe the changes in the distal end of the dissection, so as to effectively monitor the morphological changes of this lesion and explore a more effective method for monitoring the development of distal aortic dissection.
[0004] A method for assessing the development of distal aortic dissection based on morphological changes includes the following steps:
[0005] Step 1: Based on clinical images, create a 3D model of the aortic dissection region;
[0006] First, we will perform precise three-dimensional model reconstruction of the aortic dissection area based on the patient's clinical medical images, such as CTA and MRI images.
[0007] Step 2: Based on the distance between the lower edge of the celiac trunk and the distal end of the dissection region in the 3D model, measure the change in the distance between the lower edge of the celiac trunk and the distal end of the dissection region in the patient.
[0008] Step 3: Based on the results of Step 2, assess the stability of the distal tear of the interstitial space.
[0009] A method for assessing the development of distal aortic dissection based on morphological changes includes the following steps:
[0010] Step 1: Acquire clinical images;
[0011] Step 2: Based on the distance between the lower edge of the celiac trunk artery and the distal end of the dissection area in clinical imaging, measure the change in the distance between the lower edge of the celiac trunk artery and the distal end of the dissection area in the patient.
[0012] Step 3: Based on the results of Step 2, assess the stability of the distal tear of the interstitial space.
[0013] Furthermore, step 2 includes the following steps:
[0014] Step 21: Measure the distance L between the lower edge of the celiac trunk artery and the distal end of the dissection region. c-d ;
[0015] While ensuring that the morphological information of the patient's accurate three-dimensional model was not lost, we measured the distance (L) between the lower edge of the celiac trunk artery and the distal end of the dissection region. c-d The calculation formula is as follows:
[0016] L c-d =CoordinateZ c -CoordinateZ d
[0017] CoordinateZ c With CoordinateZ d These represent the z-axis coordinates of the lower border and distal end of the celiac trunk artery, respectively. As the first major arterial branch of the abdominal aorta, the lower border of the celiac trunk artery is less susceptible to compression from surrounding organs and tissues, and it is easy to locate. We use it as a reference to describe the changes in the distal tear of the dissection in patients.
[0018] Step 22: Calculate the change in distance between the lower edge of the celiac trunk artery and the distal end of the dissection region;
[0019] Furthermore, step 22 specifically includes:
[0020] L c-d,m,n =L c-d,n -L c-d,m
[0021] In the above formula, m and n represent different checks, and L c-d,m,n This means that L represents two inspections. c-d The changes in L (with dimensions in cm). c-d,m,n When it is greater than zero, it represents L. c-d The tear is increasing, and the distal tear of the intercalation is developing further. c-d,m,n When it is less than zero, it represents L. c-dThe tear is decreasing, and the distal tear of the interstitial space is improving; the extent is shrinking. When L c-d,m,n The larger the absolute value, the greater the L. c-d The more drastic the change, the more unstable the location of the distal tear in the intercalary disc. c-d,m,n When it approaches zero, it represents the interlayer region L. c-d The smaller the change, the more stable the distal tear location.
[0022] Furthermore, step 22 specifically includes:
[0023]
[0024] In the above formula, LPY c-d,m,n (Length variation Per Year) represents the length between two consecutive examinations. c-d The annual change (measured in cm / year), where T represents time. When LPY c-d,m,n When it is greater than zero, it represents L. c-d It is increasing, and the distal tear of the interlayer is developing further, when LPY c-d,m,n When it is less than zero, it represents L. c-d The condition is decreasing, and the distal tear of the interstitial space is improving, with the extent of the tear shrinking. When LPY c-d,m,n The larger the absolute value, the greater the L. c-d The more drastic the change, the more unstable the location of the distal tear in the intercalary layer, when LPY c-d,m,n When it approaches zero, it represents the interlayer region L. c-d The smaller the change, the more stable the distal tear location.
[0025] Furthermore, step 3 specifically involves: when L c-d Increase and LPY c-d,m,n The larger the value, the more unstable the distal tear location of the dissection, and the greater the involvement of the distal abdominal aorta; when the dissection area L... c-d The smaller the change, the more stable the location of the tear at the distal end of the interlayer, and the more likely the tear can be controlled; when L c-d Decrease and LPY c-d,m,n The smaller the value, the better the tear condition and the less involvement of the distal abdominal aorta.
[0026] The beneficial effects of this invention are as follows: First, the morphological analysis method demonstrated in this patent has not been mentioned in previous research for describing the morphological characteristics of distal aortic dissection. Second, these parameters can be obtained entirely based on medical imaging information, without increasing clinical measurement costs; it mainly involves reprocessing clinically acquired image information and does not increase the burden on patients. Furthermore, the measurement process for these morphological parameters is non-invasive and will not cause any harm to the patient. Finally, these morphological parameters describe the morphological characteristics of the distal dissection from another perspective, focusing more on the follow-up changes of the distal dissection tear to monitor the local morphological changes of the false lumen, providing valuable reference for clinicians. Attached Figure Description
[0027] Figure 1 This is a three-dimensional model of the aorta in this invention.
[0028] Figure 2 This is a two-dimensional planar schematic diagram of the patient's interstitial area.
[0029] Figure 3 This study describes the changes in the distance between the lower edge of the celiac trunk artery and the distal end of the dissection area during the five-year follow-up period. Detailed Implementation
[0030] The present invention will be further described below with reference to the accompanying drawings and reference numerals.
[0031] To better understand the above-mentioned objectives, features, and advantages of the present invention, the present invention will be described in detail below with reference to the accompanying drawings and specific embodiments. It should be noted that, unless otherwise specified, the embodiments and features described in these embodiments can be combined with each other.
[0032] The terms “first,” “second,” “third,” etc., are used only to distinguish descriptions and should not be interpreted as indicating or implying relative importance.
[0033] In the description of this invention, it should also be noted that, unless otherwise explicitly specified and limited, the terms "set," "install," "connect," and "link" should be interpreted broadly. For example, they can refer to a fixed connection, a detachable connection, or an integral connection; they can refer to a mechanical connection or an electrical connection; they can refer to a direct connection or an indirect connection through an intermediate medium; and they can refer to the internal connection of two components. Those skilled in the art can understand the specific meaning of the above terms in this invention based on the specific circumstances.
[0034] The specific embodiments of the present invention will be described in detail below with reference to the accompanying drawings. It should be understood that the specific embodiments described herein are for illustration and explanation only and are not intended to limit the present invention.
[0035] Example 1:
[0036] like Figure 1-2 As shown, the method for assessing the development of distal aortic dissection based on morphological changes includes the following steps:
[0037] Step 1: Based on clinical images, create a 3D model of the aortic dissection region;
[0038] First, we will reconstruct a precise three-dimensional model of the aortic dissection area based on the patient's clinical medical images, such as CTA and MRI images. Figure 1 As shown, we take the five-year follow-up results of a patient who underwent TEVAR surgery to treat aortic dissection as an example. CT angiography (CTA) images of this patient were collected 10 days before surgery, 1 day before surgery, and 6 months, 1 year, 2 years, 3 years, 4 years, and 5 years after surgery.
[0039] Step 2: Based on the distance between the lower edge of the celiac trunk and the distal end of the dissection region in the 3D model, measure the change in the distance between the lower edge of the celiac trunk and the distal end of the dissection region in the patient.
[0040] Figure 2 : A two-dimensional planar schematic diagram of the PFLT region in this patient. Where TL and FL represent the true lumen and false lumen, respectively. c-d This represents the distance between the lower border of the celiac trunk and the distal point of the PFLT.
[0041] Step 3: Based on the results of Step 2, assess the stability of the distal tear of the interstitial space.
[0042] Example 2:
[0043] A method for assessing the development of distal aortic dissection based on morphological changes includes the following steps:
[0044] Step 1: Acquire clinical images;
[0045] Step 2: Based on the distance between the lower edge of the celiac trunk artery and the distal end of the dissection area in clinical imaging, measure the change in the distance between the lower edge of the celiac trunk artery and the distal end of the dissection area in the patient.
[0046] Step 3: Based on the results of Step 2, assess the stability of the distal tear of the interstitial space.
[0047] Example 3:
[0048] Based on Examples 1 and 2, such as Figure 3 As shown, step 2 includes the following steps:
[0049] Step 21: Measure the distance L between the lower edge of the celiac trunk artery and the distal end of the dissection region. c-d ;
[0050] While ensuring that the morphological information of the patient's accurate three-dimensional model was not lost, we measured the distance (L) between the lower edge of the celiac trunk artery and the distal end of the dissection region. c-d ),like Figure 2 As shown, the calculation formula is as follows:
[0051] L c-d =CoordinateZ c -CoordinateZ d
[0052] CoordinateZ c With CoordinateZ d The z-axis coordinates of the lower border and distal end of the celiac trunk artery represent the respective coordinates. As the first major branch of the abdominal aorta, the celiac trunk artery's lower border is less susceptible to compression from surrounding organs and tissues, and its location is relatively easy. We use it as a reference to describe changes in the distal tear of the patient's dissection. Further tearing at the distal end of the dissection directly affects its progression, potentially extending the torn vessel wall to the distal abdominal aorta and its branches, posing long-term clinical risks. Therefore, we use the L values during the patient's five-year follow-up period... c-d Measurements were performed. Considering that previous studies had not highlighted the importance of this morphological parameter, we introduced it for the first time and monitored the development of the distal region of the dissection before and after surgery by observing changes in this parameter during the follow-up period. c-d <0 indicates that the false lumen is completely located above the celiac trunk artery, and the abdominal aortic segment is not involved.
[0053] Step 22: Calculate the change in distance between the lower edge of the celiac trunk artery and the distal end of the dissection region;
[0054] Figure 3 (a) represents L during the five-year follow-up period. c-d The changes are shown on the horizontal axis. The horizontal axis numbers represent the results at 10 days before surgery, 1 day before surgery, 6 months after surgery, 1 year, 2 years, 3 years, 4 years, and 5 years after surgery, respectively. (b) represents the results based on the first preoperative examination, L c-d The changes.
[0055] Example 4:
[0056] Based on Example 3 and morphological analysis, we can see that the location of the distal tear in this patient's aortic dissection is changing. Preoperative examinations showed L... c-dThe slight increase in size indicates further development of the distal tear; postoperative L c-d The significant reduction in size indicates that the TEVAR procedure also improves the distal tear, although further thrombosis may still exist locally. However, with the passage of time after surgery, L... c-d The tear is gradually increasing in size, though not very obvious, indicating that the patient may experience further development of a distal tear, potentially affecting the distal abdominal aorta and its branches. These quantitative morphological parameters describing the distal tear can provide morphological evidence for physicians to clinically assess this type of lesion. Furthermore, we can use a single L... c-d Based on the measurement results, determine the subsequent L c-d The changes. Figure 3 (b) An assessment was conducted based on the first follow-up examination 10 days prior to surgery, indicating that the distal tear had progressed further downwards both before and after surgery compared to the initial follow-up examination 10 days prior to surgery:
[0057] Step 22 specifically involves:
[0058] L c-d,m,n =L c-d,n -L c-d,m
[0059] In the above formula, m and n represent different checks, and L c-d,m,n This means that L represents two inspections. c-d The changes in L (with dimensions in cm). c-d,m,n When it is greater than zero, it represents L. c-d The tear is increasing, and the distal tear of the intercalation is developing further. c-d,m,n When it is less than zero, it represents L. c-d The tear is decreasing, and the distal tear of the interstitial space is improving; the extent is shrinking. When L c-d,m,n The larger the absolute value, the greater the L. c-d The more drastic the change, the more unstable the location of the distal tear in the intercalary disc. c-d,m,n When it approaches zero, it represents the interlayer region L. c-d The smaller the change, the more stable the distal tear location.
[0060] Example 5:
[0061] Based on Example 3, step 22 specifically includes:
[0062]
[0063] In the above formula, LPY c-d,m,n (Length variation Per Year) represents the length between two consecutive examinations. c-dThe annual change (measured in cm / year), where T represents time. When LPY c-d,m,n When it is greater than zero, it represents L. c-d It is increasing, and the distal tear of the interlayer is developing further, when LPY c-d,m,n When it is less than zero, it represents L. c-d The condition is decreasing, and the distal tear of the interstitial space is improving, with the extent of the tear shrinking. When LPY c-d,m,n The larger the absolute value, the greater the L. c-d The more drastic the change, the more unstable the location of the distal tear in the intercalary layer, when LPY c-d,m,n When it approaches zero, it represents the interlayer region L. c-d The smaller the change, the more stable the distal tear location.
[0064] Example 6:
[0065] Based on Examples 4 and 5, step 3 specifically involves: when L c-d Increase and LPY c-d,m,n The larger the value, the more unstable the distal tear location of the dissection, and the greater the involvement of the distal abdominal aorta; when the dissection area L... c-d The smaller the change, the more stable the location of the tear at the distal end of the interlayer, and the more likely the tear can be controlled; when L c-d Decrease and LPY c-d,m,n The smaller the value, the better the tear condition and the less involvement of the distal abdominal aorta.
[0066] As can be seen, during the five-year follow-up period after surgery, L c-d It has been gradually increasing, which may have long-term adverse consequences for the patient. Surgeons can also use this parameter to judge the further development of the distal dissection and provide a reference for doctors' clinical diagnosis.
[0067] This invention is not limited to the above-described optional embodiments. Anyone can derive other various forms of products under the guidance of this invention. However, regardless of any changes made in their shape or structure, any technical solution that falls within the scope of the claims of this invention shall be protected by this invention.
Claims
1. A method for assessing the development of distal aortic dissection based on morphological changes, characterized in that: Includes the following steps: Step 1: Based on clinical images, create a 3D model of the aortic dissection region; Step 2: Based on the distance between the lower edge of the celiac trunk and the distal end of the dissection region in the 3D model, measure the change in the distance between the lower edge of the celiac trunk and the distal end of the dissection region in the patient. Step 3: Based on the results of Step 2, assess the stability of the distal tear of the interstitial space.
2. A method for assessing the development of distal aortic dissection based on morphological changes, characterized in that: Includes the following steps: Step 1: Acquire clinical images; Step 2: Based on the distance between the lower edge of the celiac trunk artery and the distal end of the dissection area in clinical imaging, measure the change in the distance between the lower edge of the celiac trunk artery and the distal end of the dissection area in the patient. Step 3: Based on the results of Step 2, assess the stability of the distal tear of the interstitial space.
3. The method for assessing the development of distal aortic dissection based on morphological changes according to claim 1 or 2, characterized in that: Step 2 includes the following steps: Step 21: Measure the distance L between the lower edge of the celiac trunk artery and the distal end of the dissection region. c-d The calculation formula is as follows: L c-d < CoordinateZ c -CoordinateZ d CoordinateZ c With CoordinateZ d These represent the z-axis coordinates of the lower border and distal end of the celiac trunk artery, respectively. Step 22: Calculate the change in distance between the lower edge of the celiac trunk artery and the distal end of the dissection region.
4. The method for assessing the development of distal aortic dissection based on morphological changes according to claim 3, characterized in that: Step 22 specifically involves: L c-d,m,n =L c-d,n -L c-d,m In the above formula, m and n represent different checks, and L c-d,m,n This means that L represents two inspections. c-d The changes in (its dimension is cm).
5. The method for assessing the development of distal aortic dissection based on morphological changes according to claim 3, characterized in that: Step 22 specifically involves: In the above formula, LPY c-d,m,n (Length variation Per Year) represents the length between two consecutive examinations. c-d The annual change (measured in cm / year), where T represents time.
6. The method for assessing the development of distal aortic dissection based on morphological changes according to claim 4 or 5, characterized in that: Step 3 specifically involves: when L c-d Increase and LPY c-d,m,n The larger the value, the more unstable the distal tear location of the dissection, and the greater the involvement of the distal abdominal aorta; when the dissection area L... c-d The smaller the change, the more stable the location of the tear at the distal end of the interlayer, and the more likely the tear can be controlled; when L c-d Decrease and LPY c-d,m,n The smaller the value, the better the tear condition and the less involvement of the distal abdominal aorta.