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布加综合征合并下腔静脉梗阻介入治疗前后血流动力学参数的变化及意义

Changes and significance of hydrodynamic parameters in Budd-Chiari syndrome with obstruction of the inferior vena cava prior to and after interventional therapy.

作者信息

Lyu Lulu, Xu Peng, Ping Jie, Hu Chunfeng, Xu Kai

机构信息

The First School of Clinical Medicine, Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China.

Department of CT and MRI, Xuzhou Central Hospital, Xuzhou, Jiangsu 221009, P.R. China.

出版信息

Exp Ther Med. 2021 Mar;21(3):178. doi: 10.3892/etm.2021.9609. Epub 2021 Jan 5.

Abstract

In recent years, the role of computational fluid dynamics for Budd-Chiari syndrome evaluation has become the focus of certain studies. The purpose of the present study was to evaluate the role of computational fluid dynamics in Budd-Chiari syndrome with obstruction of the inferior vena cava (IVC). Magnetic resonance venous angiography was used to obtain original IVC and hepatic venous blood flow images from patients with Budd-Chiari syndrome. The computational fluid dynamics method was used to establish a three-dimensional model and simulate the blood flow velocity, wall shear stress and wall pressure. The results revealed that the hemodynamic parameters of Budd-Chiari syndrome were successfully simulated by computational fluid dynamics. The hemodynamic parameters of the IVC stenosis varied with the cardiac cycle. Vascular flow velocity (pre-operative, 1.64±0.10 m/sec; post-operative, 0.34±0.14 m/sec; t=34.97, P<0.001) and wall shear stress (pre-operative, 25.69±2.85 Pa; post-operative, 3.51±1.70 Pa; t=29.86, P<0.001) at the area of stenosis decreased after interventional therapy and the wall pressure increased (pre-operative, -119.33±251.50 Pa; post-operative, 1,128.42±207.70 Pa; t=17.10, P<0.001). In conclusion, the computational fluid dynamics method was able to effectively simulate the hemodynamic parameters of Budd-Chiari syndrome with obstruction of the IVC and may provide an effective quantitative method for the evaluation of vascular function post-treatment.

摘要

近年来,计算流体动力学在布加综合征评估中的作用已成为某些研究的焦点。本研究的目的是评估计算流体动力学在伴有下腔静脉(IVC)阻塞的布加综合征中的作用。采用磁共振静脉血管造影术获取布加综合征患者的原始IVC和肝静脉血流图像。运用计算流体动力学方法建立三维模型,模拟血流速度、壁面剪应力和壁面压力。结果显示,通过计算流体动力学成功模拟了布加综合征的血流动力学参数。IVC狭窄的血流动力学参数随心动周期而变化。介入治疗后,狭窄部位的血管流速(术前,1.64±0.10米/秒;术后,0.34±0.14米/秒;t = 34.97,P < 0.001)和壁面剪应力(术前,25.69±2.85帕;术后,3.51±1.70帕;t = 29.86,P < 0.001)降低,壁面压力升高(术前,-119.33±251.50帕;术后,1128.42±207.70帕;t = 17.10,P < 0.001)。总之,计算流体动力学方法能够有效模拟伴有IVC阻塞的布加综合征的血流动力学参数,并可能为治疗后血管功能评估提供一种有效的定量方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41d9/7812571/2199495534b5/etm-21-03-09609-g00.jpg

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