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基于不同类型主动脉弓中基于壁面切应力(WSS)指标分布的 B 型主动脉夹层风险评估。

Risk evaluation of type B aortic dissection based on WSS-based indicators distribution in different types of aortic arch.

机构信息

Institute of Civil Engineering and Architecture, Southwest University of Science and Technology, Mianyang 621010, China.

Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China.

出版信息

Comput Methods Programs Biomed. 2022 Jun;221:106872. doi: 10.1016/j.cmpb.2022.106872. Epub 2022 May 11.

Abstract

BACKGROUND AND OBJECTIVE

The underlying mechanism of aortic dissection (AD) remains unclear and the onset of AD is still unpredictable. Although clinical study with statistical analysis has reported that type III aortic arch may have strong correlation with type B AD (TBD), the effects of different arch types on the wall shear stress (WSS) have not been clarified.

METHODS

As a complementary work, this study numerically investigated the distribution of five WSS-based indicators in thirty aortic arches without AD, which were classified into three groups based on the arch types.

RESULTS

The distribution of most WSS indicators, such as time averaged WSS (TAWSS), oscillatory shear index (OSI) and relative residence time (RRT) had no significant difference among different types of aortic arches (P>0.05). However, a multidirectional WSS index, namely CFI, was found its maximum value was positively correlated with type III aortic arch in proximal descending aorta (p<0.001, r = 0.65).

CONCLUSIONS

It can be concluded that the enhancement or oscillation of WSS may not be the main reason of TBD is prevalence in type III arches, while the multidirectional WSS distribution may be an important factor. It can be further referred that the CFI may have a potential to predict the onset of TBD.

摘要

背景与目的

主动脉夹层(AD)的发病机制仍不清楚,AD 的发病仍然难以预测。虽然临床研究结合统计学分析报告表明,III 型主动脉弓可能与 B 型 AD(TBD)有很强的相关性,但不同弓型对壁切应力(WSS)的影响尚未阐明。

方法

作为一项补充工作,本研究数值研究了 30 例无 AD 的主动脉弓的 5 个基于 WSS 的指标的分布,这些主动脉弓根据弓型分为三组。

结果

大多数 WSS 指标(如平均壁切应力(TAWSS)、振荡剪切指数(OSI)和相对居留时间(RRT))的分布在不同类型的主动脉弓之间没有显著差异(P>0.05)。然而,一个多向 WSS 指标,即 CFI,发现其最大值与降主动脉近端的 III 型主动脉弓呈正相关(p<0.001,r=0.65)。

结论

可以得出结论,WSS 的增强或振荡可能不是 TBD 在 III 型弓中流行的主要原因,而多向 WSS 分布可能是一个重要因素。可以进一步认为,CFI 可能有预测 TBD 发病的潜力。

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