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      "labelKo": "양방향 균형 파열구(11.5mm·재진입비 0.88) — 저압력차 약물치료(OMT) 권고",
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      "caseId": "TBAD-CASE-03-VISCERAL-HOLD",
      "labelEn": "False-Lumen Left Renal Origin + Tiny Re-entry (0.06) — Visceral Malperfusion HOLD",
      "labelKo": "가강 기시 신동맥·미세 재진입구(0.06) — 단순 스텐트 폐쇄 시 장기허혈 위험 HOLD",
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        "postFlThrombosisIndex": 0.968,
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        "reentryAreaRatio": 0.06,
        "visceralFlOrigin": true
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      }
    },
    {
      "caseId": "TBAD-CASE-04-HYPERTENSIVE-IMH",
      "labelEn": "Refractory Hypertensive Micro-Tear / IMH (4.4 mm, 184/102 mmHg) — Wall-Stress Alert",
      "labelKo": "난치성 고혈압 미세파열·벽내혈종(4.4mm, 184/102mmHg) — 외벽 라플라스 장력 경보",
      "metrics": {
        "clinicalPlan": "URGENT_IV_ANTI_IMPULSE_AND_SERIAL_CTA",
        "entryTearMm": 4.4,
        "postDiastolicDeltaPPeakMmHg": -19.8,
        "postFlThrombosisIndex": 0.921,
        "postLaplaceWallStressKpa": 100.91,
        "postVisceralBranchFlowRatio": 1.0,
        "preDiastolicDeltaPPeakMmHg": 33.38,
        "preLaplaceWallStressKpa": 191.35,
        "reentryAreaRatio": 0.14,
        "visceralFlOrigin": false
      },
      "verdict": "PASS",
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      }
    }
  ],
  "findings": [
    {
      "category": "Clinical Safety Interlock",
      "detailEn": "When renal or mesenteric perfusion depends on the false lumen with distal re-entry ratio < 0.15, virtual proximal stent-graft closure drops branch flow below 15% of baseline, triggering mandatory fenestrated/PETTICOAT planning HOLD.",
      "detailKo": "원위 재진입구가 협소한 상태에서 신동맥·상장간막동맥이 가강에서 기시할 경우 단순 근위부 폐쇄 시 분지 유량이 85% 이상 급감하므로 천공형·분지형 시술 전환 HOLD를 강제함.",
      "id": "AORTA-BOUNDARY-01",
      "status": "HOLD",
      "titleEn": "False-Lumen Visceral/Renal Origin Contraindicates Simple Proximal Entry Coverage",
      "titleKo": "가강 단독 기시 신동맥·장간막동맥 증례의 단순 TEVAR 폐쇄 금기(HOLD)"
    },
    {
      "category": "Model Physics Scope",
      "detailEn": "Current solver resolves exact bifurcated orifice Bernoulli losses, flap recoil asymmetry, and Laplace tension, but spiral helical secondary vortices in tortuous arches require patient-specific 3D FSI / 4D-Flow MRI concordance.",
      "detailKo": "본 엔진은 파열구 베르누이 손실·내막판 역류 비대칭·라플라스 벽장력을 정밀 계산하나, 심한 대동맥궁 굴곡부의 3차원 나선형 와류 정량화는 4D-Flow MRI 실측 대조가 필요함.",
      "id": "AORTA-BOUNDARY-02",
      "status": "HOLD",
      "titleEn": "Lumped-Inertial 1D/0D Network Requires 3D CTA Centerline & 4D-Flow MRI Patient Pairing",
      "titleKo": "집중정수-관성 혈류망 모델의 환자별 3D CTA 중심선·4D-Flow MRI 정합 한계 명시"
    },
    {
      "category": "Statutory Regulatory Gate",
      "detailEn": "Automated G1–G4 biomechanical verification never substitutes for vascular surgeon pre-operative sizing sign-off or prospective CTA/4D-Flow IRB clinical validation.",
      "detailKo": "자동화된 G1–G4 생체역학 검증 통과는 혈관외과 전문의 최종 시술계획 서명 및 다기관 전향적 CTA/4D-Flow 임상시험을 대체하지 않으며 법정 외부 게이트로 정직하게 분리됨.",
      "id": "AORTA-STATUTORY-03",
      "status": "EXT",
      "titleEn": "MFDS Pre-Operative Endovascular Sizing SaMD & ASME V&V 40 Clinical Validation Pending",
      "titleKo": "식약처 흉부대동맥 시술계획 SaMD 심사 및 다기관 혈관외과 임상 실증(S-EXT) 분리"
    }
  ],
  "gates": {
    "G1": {
      "detailEn": "Verified SHA-256 of MIMIC-IV Demo v2.2 invasive arterial pressure tables and disjoint 120/240 train/test Stanford Type B split.",
      "detailKo": "MIMIC-IV 침습적 동맥압 원천 해시 고정 및 스탠퍼드 B형 120/240 학습·검증 형상 완전 분리 확인.",
      "observed": {
        "errors": [],
        "hashOverlap": 0,
        "invasiveArterialSubjects": 56,
        "testCount": 240,
        "trainCount": 120
      },
      "status": "PASS",
      "titleEn": "MIMIC-IV Arterial Provenance & Zero Geometry Leakage",
      "titleKo": "MIMIC-IV 동맥압 입력 무결성 및 형상 분할 누수 검증"
    },
    "G2": {
      "detailEn": "Independently integrated Q_in vs (Q_tl_out + Q_fl_out) across periodic cycles (< 1e-4 mL) and confirmed > +12 mmHg diastolic FL paradox with post-TEVAR decompression.",
      "detailKo": "진강·가강 박동 주기 유입·유출 적분 오차 10⁻⁴ mL 미만 및 대형 파열구 이완기 가강 과압(>12 mmHg)·TEVAR 감압 재현 확인.",
      "observed": {
        "errors": [],
        "maxCohortContinuityMl": 8.416e-05,
        "maxWaveformContinuityMl": 3.928e-05,
        "paradoxPostDeltaPMmHg": -13.61,
        "paradoxPreDeltaPMmHg": 41.0,
        "rk4StepDriftMmHg": 0.061
      },
      "status": "PASS",
      "titleEn": "Cycle Flow Continuity & Diastolic FL Over-Pressurization",
      "titleKo": "박동 주기 유량 보존(<10⁻⁴ mL) 및 이완기 가강 과압 검증"
    },
    "G3": {
      "detailEn": "Recomputed Mann-Whitney AUROC, 600-replicate bootstrap 95% CI, Brier, and ECE on n=240 locked Type B geometries against >=40 mm diameter baseline.",
      "detailKo": "동결 테스트 코호트(n=240) 대상 대동맥 최대직경(≥40mm) 기준선 대비 혈역학·라플라스 예측 모델 성능 독립 재검산 일치.",
      "observed": {
        "aurocGainOverBaseline": 0.277241,
        "baselineDiameterAuroc": 0.549622,
        "errors": [],
        "recomputedAuroc": 0.826863,
        "recomputedCi95": [
          0.772068,
          0.874575
        ]
      },
      "status": "PASS",
      "titleEn": "Solver-Free Locked-Cohort AUROC & Calibration Recomputation",
      "titleKo": "솔버 분리 독립 AUROC·신뢰구간·보정오차 재검산"
    },
    "G4": {
      "detailEn": "Confirmed automatic HOLD when mesenteric/renal perfusion originates from false lumen with tiny distal re-entry prior to virtual TEVAR closure.",
      "detailKo": "원위 재진입구가 협소한 가강 기시 신동맥 증례에서 단순 근위부 스텐트 폐쇄 시 발생하는 급성 신허혈 위험 자동 보류(HOLD) 작동 확인.",
      "observed": {
        "errors": [],
        "humanAuditorSignature": null,
        "visceralHoldTriggered": true,
        "visceralPostBranchFlowRatio": 0.1411
      },
      "status": "PASS",
      "titleEn": "Visceral Branch Malperfusion Safety HOLD & Statutory Gate",
      "titleKo": "가강 기시 내장·신동맥 허혈 위험 HOLD 및 인허가 경계 보존"
    }
  },
  "humanAuditorSignature": null,
  "inputProvenance": [
    {
      "label": "PhysioNet MIMIC-IV Demo v2.2 ICU Invasive Arterial Waveforms/Envelopes (chartevents.csv.gz)",
      "records": 668862,
      "sha256": "90f096ad3db847ed1aaec073f8d86053c51fea7b616d3b046410e030f083d560"
    },
    {
      "label": "PhysioNet MIMIC-IV Demo v2.2 ICU Parameter Dictionary (d_items.csv.gz)",
      "records": 4014,
      "sha256": "1690467a822345226a041c1149237c418aa60098c6b699fb4cef64d73588a01f"
    }
  ],
  "narrative": {
    "headlineEn": "Bifurcated True/False-Lumen RK4 solver calibrated on MIMIC-IV arterial envelopes achieves locked n=240 Type B expansion AUROC 0.827 (vs 0.550 for >=40 mm diameter guideline) with 3.93e-05 mL cycle continuity residual.",
    "headlineKo": "MIMIC-IV 침습적 동맥압으로 보정된 박동성 진강·가강 RK4 혈류해법이 스탠퍼드 B형 동결 코호트(n=240) 후기 확장 예측 AUROC 0.827(기존 직경 ≥40mm 기준 0.550) 및 유량 보존 오차 3.93e-05 mL를 달성.",
    "methodEn": "Solves a 6-state coupled pulsatile True/False-Lumen fluid-structure ODE network with quadratic Bernoulli proximal/distal tear losses, mobile intimal-flap diastolic check-valve recoil, and Laplace circumferential wall tension, paired with virtual TEVAR proximal entry occlusion and visceral malperfusion safety interlocks.",
    "methodKo": "근위·원위 내막 파열구의 이차 베르누이 손실, 가동성 내막판의 이완기 역류 비대칭, 가강 외벽 라플라스 장력을 결합한 6-상태 박동성 RK4 미분방정식을 극한 주기까지 적분하고 가상 TEVAR 폐쇄 후 감압 효과와 내장동맥 허혈 위험(HOLD)을 동시 판정."
  },
  "overallStatus": "PASS",
  "package": "aorta11_31",
  "primaryMetric": {
    "baselineNameEn": "Conventional Max Aortic Diameter >= 40 mm Guideline",
    "baselineNameKo": "기존 임상 가이드라인 최대 대동맥 직경(≥40mm) 단독 기준",
    "baselineValue": 0.549622,
    "ci95": [
      0.772068,
      0.874575
    ],
    "denominator": 240,
    "nameEn": "Late Aortic Expansion Risk Stratification AUROC (Locked n=240)",
    "nameKo": "후기 대동맥 확장·불량 재형성 위험도 예측 AUROC (동결 n=240)",
    "targetSpec": "AUROC >= 0.80 & +0.10 over >=40 mm diameter baseline",
    "unit": "AUROC",
    "value": 0.826863
  },
  "rfpCode": "11-1 [3-1]",
  "runSha256": "3315044dd5f8e380db26dddd58a4d740498dd79866f027ff2e75da6db9322f1e",
  "schemaVersion": 1,
  "secondaryMetrics": [
    {
      "detailEn": "Target < 1.0e-4 mL across bifurcated True/False-Lumen RK4 cycle",
      "detailKo": "진강·가강 분기 혈류역학 주기 적분 질량보존 기준(< 10⁻⁴ mL)",
      "id": "cycle_flow_continuity_ml",
      "nameEn": "Max Cycle-Integrated Flow Continuity Residual",
      "nameKo": "박동 주기 유량 보존 최대 적분 잔차",
      "status": "PASS",
      "unit": "mL/beat",
      "value": 3.93e-05
    },
    {
      "detailEn": "Reproduces Tsai/IRAD clinical diastolic FL paradox (> +12 mmHg)",
      "detailKo": "미세 원위 재진입구 동반 시 이완기 가강 역설적 과압(> +12 mmHg) 재현",
      "id": "diastolic_paradox_delta_p_mmhg",
      "nameEn": "Large-Tear Diastolic False-Lumen Over-Pressurization (ΔP)",
      "nameKo": "대형 근위 파열구 이완기 가강 과압(ΔP_transmural)",
      "status": "PASS",
      "unit": "mmHg",
      "value": 41.0
    },
    {
      "detailEn": "Negative transmural gradient confirms True-Lumen re-expansion",
      "detailKo": "음(-)의 경벽 압력차 전환으로 진강 재팽창 및 가강 혈전화 유도 확인",
      "id": "post_tevar_delta_p_mmhg",
      "nameEn": "Virtual TEVAR Post-Closure Transmural ΔP",
      "nameKo": "가상 TEVAR 근위부 폐쇄 후 경벽 압력차(ΔP)",
      "status": "PASS",
      "unit": "mmHg",
      "value": -13.61
    },
    {
      "detailEn": "10-bin Expected Calibration Error (ECE) = 0.0997",
      "detailKo": "10구간 기대보정오차(ECE) = 0.0997",
      "id": "brier_calibration_score",
      "nameEn": "Locked Cohort Brier Probability Score",
      "nameKo": "동결 테스트 코호트 확률 보정 Brier 점수",
      "status": "PASS",
      "unit": "Brier",
      "value": 0.177808
    },
    {
      "detailEn": "Triggers mandatory fenestrated/branched EVAR safety HOLD (< 0.50)",
      "detailKo": "관류비 0.50 미만 급감 시 단순 스텐트 시술 금지 및 천공형/분지형 계획 보류",
      "id": "visceral_branch_hold_ratio",
      "nameEn": "False-Lumen Renal Branch Post-TEVAR Perfusion Ratio",
      "nameKo": "가강 기시 신동맥 가상 폐쇄 후 관류 유지비",
      "status": "HOLD",
      "unit": "ratio",
      "value": 0.1411
    }
  ],
  "solverFreeAst": {
    "file": "audit.py",
    "importedModules": [
      "__future__",
      "audit_lib.independent_metrics",
      "audit_lib.track_contract",
      "json",
      "pathlib",
      "typing"
    ],
    "solverFree": true,
    "violations": []
  }
}