Segmentation and Embolization Simulation of Uterine Artery for Cesarean Scar Pregnancy

doi:10.19678/j.issn.1000-3428.0070087

Abstract

Abstract:

In women who have undergone a cesarean section, the gestational sac can get implanted at the surgical incision site during subsequent pregnancies, which can lead to uterine rupture and severe hemorrhage, threatening the fertility and even life of the patient. Currently, uterine artery embolization is the preferred treatment for such conditions; however, the procedure relies heavily on the expertise of the doctor and is challenging to customize based on individual patient differences. Therefore, a simulation scheme for uterine artery embolization is proposed. First, a semantic segmentation algorithm for uterine artery vessels is introduced, utilizing a dual-branch encoding structure and a feature focus fusion model to enhance the use of global features by the neural network, thereby achieving semantic segmentation of uterine artery vessel CT images. Second, a combined refinement and tracking centerline extraction method is used to construct a three-dimensional model of the vessels based on the centerline. Finally, a numerical simulation method combining computational fluid dynamics and discrete element methods is employed to simulate the uterine artery embolization. The experimental results show that the semantic segmentation algorithm significantly improves the segmentation accuracy of uterine artery vessel CT images. The centerline extraction-based three-dimensional vessel model reconstruction retains the true structure of the vessels while avoiding cumbersome postprocessing. The numerical simulation of the embolization of the uterine artery vessels intuitively demonstrates the embolization formation process and provides a reference for doctors in formulating surgical plans.

Key words: uterine artery embolization, medical image segmentation, three-dimensional model, vascular centerlines, embolization simulation

摘要：

对于接受过剖宫产的女性, 在其后续妊娠中, 孕囊有着床在手术切口处的风险, 极易导致宫体破裂和大出血等并发症, 危及患者的生育功能乃至生命安全。子宫动脉栓塞术是目前治疗此类疾病的首选方案, 但该栓塞手术的操作严重依赖医生的专业经验, 且难以根据患者的个体差异设定不同的组合配比。为此, 提出一种实现子宫动脉栓塞模拟的方案。首先, 提出一种面向子宫动脉血管的语义分割算法, 通过引入双分支编码结构和特征聚焦融合模型, 提高神经网络对全局特征的利用, 实现对子宫动脉血管CT图像的语义分割。其次, 采用细化和追踪相结合的中心线提取方法, 基于中心线重建血管三维模型。最后, 采用计算流体力学与离散元耦合的数值模拟方法, 实现子宫动脉栓塞过程的模拟。实验结果表明, 语义分割算法有效地提高了子宫动脉血管CT图像的分割精度。基于中心线提取的血管三维模型重建方案, 保留了血管真实结构, 同时避免了繁琐的后处理操作。面向子宫动脉血管的栓塞数值模拟, 直观展示了栓塞形成过程, 同时为医生制定手术方案提供参考。

关键词: 子宫动脉栓塞术, 医学图像分割, 三维模型, 血管中心线, 栓塞模拟

TAN Zihong, PAN An, TONG Jing, LIU Yaohui, WEI Jian. Segmentation and Embolization Simulation of Uterine Artery for Cesarean Scar Pregnancy[J]. Computer Engineering, 2026, 52(6): 339-351.

谭梓鸿, 潘安, 童晶, 刘耀辉, 韦剑. 面向瘢痕部位妊娠的子宫动脉分割与栓塞模拟[J]. 计算机工程, 2026, 52(6): 339-351.

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https://www.ecice06.com/EN/Y2026/V52/I6/339

Figures/Tables 15

Fig.1 The overall procedure of proposed method

Fig.2 Structure of STDU-Net network

Fig.3 Schematic diagram of vascular disconnection position

Fig.4 Schematic diagram of vascular disconnection position connection

Fig.5 Description of the calculation of the possibility function of the blood vascular center point

Fig.6 Comparison of 3D modeling results

Fig.7 Comparison of experimental results of two methods

Fig.8 Uterine artery vascular model based on centerline reconstruction

Fig.9 Discrete element simulation results of "microparticle-type" embolism

Fig.10 Discrete element simulation results of "concrete-type" embolism

Fig.11 Schematic diagram and simulation results of two different embolization methods

Fig.12 Simulation results of different embolization ratio schemes

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