Suppr超能文献

B 型主动脉夹层中的瘤样扩张:评估患者特定入口条件对关键血流动力学指标的影响。

Aneurysmal growth in type-B aortic dissection: assessing the impact of patient-specific inlet conditions on key haemodynamic indices.

机构信息

Department of Mechanical Engineering, University College London, London, UK.

Wellcome-EPSRC Centre for Interventional Surgical Sciences, London, UK.

出版信息

J R Soc Interface. 2023 Sep;20(206):20230281. doi: 10.1098/rsif.2023.0281. Epub 2023 Sep 20.

Abstract

Type-B aortic dissection is a cardiovascular disease in which a tear develops in the intimal layer of the descending aorta, allowing pressurized blood to delaminate the layers of the vessel wall. In medically managed patients, long-term aneurysmal dilatation of the false lumen (FL) is considered virtually inevitable and is associated with poorer disease outcomes. While the pathophysiological mechanisms driving FL dilatation are not yet understood, haemodynamic factors are believed to play a key role. Computational fluid dynamics (CFD) and 4D-flow MRI (4DMR) analyses have revealed correlations between flow helicity, oscillatory wall shear stress and aneurysmal dilatation of the FL. In this study, we compare CFD simulations using a patient-specific, three-dimensional, three-component inlet velocity profile (4D IVP) extracted from 4DMR data against simulations with flow rate-matched uniform and axial velocity profiles that remain widely used in the absence of 4DMR. We also evaluate the influence of measurement errors in 4DMR data by scaling the 4D IVP to the degree of imaging error detected in prior studies. We observe that oscillatory shear and helicity are highly sensitive to inlet velocity distribution and flow volume throughout the FL and conclude that the choice of IVP may greatly affect the future clinical value of simulations.

摘要

B 型主动脉夹层是一种心血管疾病,其中降主动脉的内膜层出现撕裂,导致高压血液将血管壁的各层分层。在接受药物治疗的患者中,假腔(FL)的长期扩张被认为几乎是不可避免的,并且与较差的疾病预后相关。虽然导致 FL 扩张的病理生理机制尚未被理解,但血流动力学因素被认为起着关键作用。计算流体动力学(CFD)和 4D 流 MRI(4DMR)分析表明,血流螺旋度、振荡壁切应力与 FL 的瘤样扩张之间存在相关性。在这项研究中,我们比较了使用从 4DMR 数据中提取的患者特定的三维三分量入口速度分布(4D IVP)进行 CFD 模拟与使用广泛用于缺少 4DMR 的流速匹配均匀和轴向速度分布的模拟。我们还通过将 4D IVP 缩放为先前研究中检测到的成像误差程度来评估 4DMR 数据中的测量误差的影响。我们观察到,振荡剪切力和螺旋度对 FL 内的入口速度分布和流量非常敏感,并得出结论,IVP 的选择可能会极大地影响模拟的未来临床价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c18a/10509589/eec05878d660/rsif20230281f01.jpg

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验