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腹主动脉瘤血流动力学与腔内血栓形成的纵向比较

A longitudinal comparison of hemodynamics and intraluminal thrombus deposition in abdominal aortic aneurysms.

作者信息

Arzani Amirhossein, Suh Ga-Young, Dalman Ronald L, Shadden Shawn C

机构信息

Mechanical Engineering, University of California, Berkeley, California; and.

Division of Vascular Surgery, Stanford University, Stanford, California.

出版信息

Am J Physiol Heart Circ Physiol. 2014 Dec 15;307(12):H1786-95. doi: 10.1152/ajpheart.00461.2014. Epub 2014 Oct 17.

Abstract

Abdominal aortic aneurysm (AAA) is often accompanied by in traluminal thrombus (ILT), which complicates AAA progression and risk of rupture. Patient-specific computational fluid dynamics modeling of 10 small human AAA was performed to investigate relations between hemodynamics and ILT progression. The patients were imaged using magnetic resonance twice in a 2- to 3-yr interval. Wall content data were obtained by a planar T1-weighted fast spin echo black-blood scan, which enabled quantification of thrombus thickness at midaneurysm location during baseline and followup. Computational simulations with patient-specific geometry and boundary conditions were performed to quantify the hemodynamic parameters of time-averaged wall shear stress (TAWSS), oscillatory shear index (OSI), and mean exposure time at baseline. Spatially resolved quantifications of the change in ILT thickness were compared with the different hemodynamic parameters. Regions of low OSI had the strongest correlation with ILT growth and demonstrated a statistically significant correlation coefficient. Prominent regions of high OSI (>0.4) and low TAWSS (<1 dyn/cm(2)) did not appear to coincide with locations of thrombus deposition.

摘要

腹主动脉瘤(AAA)常伴有腔内血栓(ILT),这使AAA的进展和破裂风险变得复杂。对10例小型人类AAA进行了患者特异性计算流体动力学建模,以研究血流动力学与ILT进展之间的关系。患者在2至3年的间隔内接受了两次磁共振成像。通过平面T1加权快速自旋回波黑血扫描获得壁内容数据,这使得能够在基线和随访期间量化动脉瘤中部位置的血栓厚度。使用患者特异性几何形状和边界条件进行计算模拟,以量化基线时的时间平均壁面切应力(TAWSS)、振荡切变指数(OSI)和平均暴露时间等血流动力学参数。将ILT厚度变化的空间分辨量化与不同的血流动力学参数进行比较。低OSI区域与ILT生长的相关性最强,并显示出具有统计学意义的相关系数。高OSI(>0.4)和低TAWSS(<1 dyn/cm²)的显著区域似乎与血栓沉积位置不一致。

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