主动脉夹层近心端不同破口形态下的血流动力学分析

Hemodynamic Analysis on Proximal End of the Aortic Dissection with Different Rupture Shapes

目的探索病变后主动脉夹层的血流动力学性能,为胸主动脉夹层(thoracic aortic dissection,TAD)患者治疗提供更加科学的依据。方法基于1例复杂Stanford B型主动脉夹层患者的计算机断层扫描血管造影(computed tomography angiography,CTA)影像数据,建立个性化主动脉夹层近心端不同破口形态(H、O、V型)的夹层模型,结合计算流体动力学(computational fluid dynamics,CFD)与形态学分析方法,分析破口截面速度、血流状态、壁面压力以及壁面剪切力(wall shear stress,WSS)分布。结果 H型破口类型在破裂入口处的流速、最高压强差、WSS占比都表现出较其他两种类型较大的血流动力学参数,H型破口类型夹层破裂风险最大,V型次之,O型最小。结论研究结果为病例进一步数值分析和制定治疗方案提供有效的参考。

Objective To explore hemodynamic performance of the aortic dissection after lesions,so as to provide a more scientific basis for patient treatment. Methods Based on computed tomography angiography( CTA)image data from a patient with complex Stanford B-type aortic dissection,the personalized aortic dissection models with different rupture shapes( H-type,O-type,and V-type) at proximal end of the aortic dissection were established. Combined with computational fluid dynamics( CFD) and morphological analysis method,distributions of the velocity at rupture section,the blood flow,the wall pressure and the wall shear stress( WSS)were analyzed. Results The flow velocity,the highest pressure difference and the WSS proportion at entrance of the H-shaped rupture showed larger hemodynamic parameters than those of the other two types. The risk of dissection rupture for type H was the largest,while type V was in the middle,and type O was the smallest.Conclusions This study provides an effective reference for further numerical analysis the cases and formulation of treatment plans.