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气泡与周围微血管之间的振荡相互作用及其对冲击波碎石术临床血管损伤的影响。

Oscillatory interaction between bubbles and confining microvessels and its implications on clinical vascular injuries of shock-wave lithotripsy.

作者信息

Qin Shengping, Hu Yuantai, Jiang Qing

机构信息

Department of Mechanical Engineering, University of California, Riverside, CA 92521, USA.

出版信息

IEEE Trans Ultrason Ferroelectr Freq Control. 2006 Jul;53(7):1322-9. doi: 10.1109/tuffc.2006.1665080.

Abstract

This paper presents a detailed study of the oscillation characteristics of a bubble confined inside a deformable microvessel, whose size is comparable with the bubble size. The vessel's compliance is characterized by a nonlinear relation between the intraluminal pressure and the expansion ratio of the vessel radius, which represents the variation of the vessel stiffness with the pressure of the filling liquid. In this analysis, an initially spherical bubble evolves into an ellipsoid, and the asymmetric oscillation appears immediately after the driving pressure is applied and magnifies with oscillation cycles. Compared with the symmetric oscillation in an unconstrained environment, the vessel constraint makes the bubble contract significantly more and subsequently expand in a more violent rebound, inducing substantially larger peaks of the intraluminal pressure exerted on the vessel wall. A larger initial bubble/vessel radius ratio leads to not only a larger peak but also a higher oscillation frequency of the intraluminal pressure, which are the two most dominating parameters in determining the vessel's failure under cyclic loading. The numerical results have further shown that an increase of the vessel wall stiffness strengthens the asymmetric effect, i.e., a larger peak of the intraluminal pressure with a higher oscillation frequency, and so does a larger pre-existing pressure in the liquid filling the vessel. These findings imply that the asymmetric effect is one of the primary mechanisms for clinical injuries of capillary and small blood vessels and for the higher risk of pediatric and hypertension patients in shock wave lithotripsy.

摘要

本文详细研究了限制在可变形微管内的气泡的振荡特性,该微管的尺寸与气泡大小相当。血管的顺应性由管腔内压力与血管半径膨胀率之间的非线性关系表征,这代表了血管刚度随填充液体压力的变化。在该分析中,初始为球形的气泡演变成椭球体,并且在施加驱动压力后立即出现不对称振荡,并随着振荡周期而放大。与无约束环境中的对称振荡相比,血管约束使气泡收缩得更明显,随后在更剧烈的反弹中膨胀,从而在血管壁上产生显著更大的管腔内压力峰值。较大的初始气泡/血管半径比不仅导致更大的峰值,还导致管腔内压力更高的振荡频率,这是确定血管在循环加载下失效的两个最主要参数。数值结果进一步表明,血管壁刚度的增加会增强不对称效应,即管腔内压力的更大峰值和更高的振荡频率,填充血管的液体中预先存在的较大压力也会如此。这些发现表明,不对称效应是毛细血管和小血管临床损伤以及小儿和高血压患者在冲击波碎石术中具有更高风险的主要机制之一。

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