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耦合血流动力学-动脉壁相互作用对具有可变血管壁特性的真实肺动脉顺应性的影响。

Influence of coupled hemodynamics-arterial wall interaction on compliance in a realistic pulmonary artery with variable intravascular wall properties.

作者信息

Hebbar Ullhas U, Banerjee Rupak K

机构信息

593 Rhodes Hall, Department of Mechanical Engineering, University of Cincinnati, OH, 45221, United States.

593 Rhodes Hall, Department of Mechanical Engineering, University of Cincinnati, OH, 45221, United States.

出版信息

Med Image Anal. 2019 Oct;57:56-71. doi: 10.1016/j.media.2019.06.008. Epub 2019 Jun 21.

Abstract

Pulmonary hypertension is characterized by elevation of pulmonary artery (PA) pressure (p) and structural remodeling of the PA wall, leading to reduction in arterial compliance (c). As a step towards improving diagnosis of pulmonary disease, we use the PA branch geometry (main pulmonary artery (MPA) branching into left (LPA) and right (RPA) pulmonary arteries) obtained from MRI in conjunction with an inverse algorithm to obtain the pre-stress level in the artery walls. Next, a coupled blood-wall interaction (BWI) calculation provides hemodynamic information as well as compliance of the PA walls. We show that the computed load-free geometry from the inverse algorithm exhibits a 27.8% lower inner diameter (d) and 18.5% lower outer d compared to the in vivo geometry from MRI. Further, the mean p computed from the BWI computation in the main PA (p) is within 4% of the mean p (n-numerical; e-experimental). Also, the mean Q computed in the left PA (Q) is within 10% of the mean Q. Finally, the compliance c is computed to be 27% lower than c, while the c is computed to be 20.4% lower than c. Importantly, the PA shows significant intra-vascular variation in compliance, with the MPA showing higher overall compliance compared to the LPA (3.5-4 times).

摘要

肺动脉高压的特征是肺动脉(PA)压力(p)升高以及肺动脉壁的结构重塑,导致动脉顺应性(c)降低。作为改善肺部疾病诊断的一步,我们利用从磁共振成像(MRI)获得的肺动脉分支几何结构(主肺动脉(MPA)分支为左(LPA)、右(RPA)肺动脉)并结合逆算法来获取动脉壁中的预应力水平。接下来,通过耦合的血壁相互作用(BWI)计算可提供血流动力学信息以及肺动脉壁的顺应性。我们发现,与MRI的体内几何结构相比,逆算法计算出的无载荷几何结构的内径(d)降低了27.8%,外径降低了18.5%。此外,主肺动脉(p)中BWI计算得出的平均p与平均p(n-数值;e-实验)相差在4%以内。同样,左肺动脉(Q)中计算得出的平均Q与平均Q相差在10%以内。最后,计算得出的顺应性c比c低27%,而c比c低20.4%。重要的是,肺动脉在血管内的顺应性存在显著差异,主肺动脉的总体顺应性高于左肺动脉(3.5至4倍)。

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