PMC5319967_01
(A) Rendering of the patient-specific mesh at end-diastole, generated based on echocardiographic data obtained at 23.1 weeks. Bar graph showing the morphometric match between echocardiographic data (white bars) and patient-specific finite element (FE) model (black bars) at 23.1 weeks. (B) Comparison of model shape and ventricular filling between reference FE model of healthy fetal left ventricle (LV) model (white bars) and patient-specific LV model (black bars). (C) Simulation of LV cavity growth in patient-specific model (black dotted line) and its comparison to clinically observed growth for the patient (open triangles) and normal LV growth (solid circles and solid line). (D) Bar graph showing the morphometric match between echocardiographic data (white bars) and patient-specific FE model (black bars) at 30.1 weeks.
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F6
In a blinded case study, using echocardiographic data (for LV geometry) from a severely hypoplastic fetus at 23.1 weeks as the input, we constructed a patient-specific FE model (Figure 6A). The patient-specific FE model was in good agreement with the echocardiography data with highest variability in WT dimension from apex to base (Figure 6A). At end-diastole, the current patient-specific model presented with a significantly lower ventricular filling volume at 0.187 mL, decreased LA:SA ratio at 1.2, and decreased WT relative to a normal healthy LV (Figure 6B). The simulated growth of the patient-specific model predicted a severely hypoplastic LV at birth, consistent with the patient diagnosis (Figure 6C). The patient-specific growth model predicted a consistent match in the observed reduction in the measured LV cavity volume (Figure 6C) and end-diastolic LV geometric dimensions (Figure 6D) at 30.1 weeks, to within 15% clinical error based on echocardiographic measurements.
PMC5319967_02
(A) Rendering of the patient-specific mesh at end-diastole, generated based on echocardiographic data obtained at 31 weeks. Bar graph showing the morphometric match between echocardiographic data (white bars) and patient-specific finite element (FE) model (black bars) at 31 weeks. (B) Comparison of model shape and ventricular filling between reference FE model of healthy fetal left ventricle (LV) model (white bars) and patient-specific LV model (black bars). (C) Simulation of LV cavity growth in patient-specific model (black dotted line) and its comparison to clinically observed growth for the patient (open triangles) and normal LV growth (solid circles and solid line). (D) Bar graph showing the morphometric match between echocardiographic data (white bars) and patient-specific FE model (black bars) at 39 weeks.
fped-05-00025-g007.jpg
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F7
In a blinded case study, using echocardiographic data (LV geometry) from a borderline hypoplastic fetus at 31 weeks as the input, we constructed a well-matched patient-specific FE model (Figure 7A). At end-diastole at 31 weeks, the patient-specific model had a significantly lower ventricular filling volume, increased LA:SA ratio, and increased WT relative to a normal healthy LV (Figure 7B). The simulated growth of the patient-specific model predicted a borderline hypoplastic LV at birth, consistent with the patient diagnosis (Figure 7C). The patient-specific growth model predicted a consistent match between the measured LV cavity volume (Figure 7C) and end-diastolic LV geometric dimensions (Figure 7D) at 39 weeks, to within 15% clinical error based on echocardiographic measurements.
PMC5319967_03