基于计算机断层扫描图像的房颤患者左心耳封堵前后的血流模拟

Blood flow simulation in patients with atrial fibrillation before and after left atrial appendage occlusion based on CT image

为探讨患者左心耳封堵前后的血流动力学变化,本研究建立了基于CT图像的左心耳封堵前后的计算流体力学(computational fluid dynamics,CFD)模型,并进行数值模拟。首先,利用房颤患者的CT图像重建得到三维模型;然后,对CFD模型进行血流动力学数值模拟,得到血流速度、时均壁面剪切应力(time-average wall shear stress,TAWSS)、震荡剪切指数(oscillation shear index,OSI)等与血栓形成有关的血流动力学参数,并比较患者在封堵前后的参数变化。仿真结果显示,左心耳封堵可改善心房内部血流紊乱状态,改善心房壁面的TAWSS和OSI分布,可在一定程度上有效降低患者发生血栓栓塞的风险。该研究可为临床医学提供一定的理论支撑。

To investigate the hemodynamic changes of patients before and after left atrial appendage occlusion,we established a computational fluid dynamics(CFD)model before and after occlusion of the left atrial appendage based on CT images and perform numerical simulation.Firstly,a three-dimensional model was reconstructed by using CT images of patients with atrial fibrillation.Then,hemodynamic numerical simulation was performed on the CFD model.Hemodynamic parameters such as blood flow velocity,time average wall shear stress(TAWSS)and oscillation shear index(OSI)were obtained and compared before and after occlusion.Simulation results showed that the left atrial ear could improve the state of intra-atrial blood flow disorder,and improve the distribution of TAWSS and OSI on the atrial wall,which could effectively reduce the risk of thromboembolism in patients to a certain extent.It can provide some theoretical support for clinical medicine.