Influence of morphology and hemodynamics on thrombosis in kawasaki disease patients

Kawasaki Disease(KD)patients with co-occurrent coronary artery aneurysms(CAAs)are prone to thrombosis.This study explores the thrombotic influence of morphology and hemodynamics in KD patients with CAAs.Patient-specific computed tomography angiogram images of 9 patients were used to rebuild coronary models(including 23 aneurysms;10 in thrombosed group,and 13 in non-thrombosed group)and perform computational simulations to obtain the hemodynamic parameters.The thrombosed and non-thrombosed groups were compared in terms of six parameters,namely,the maximum diameter(D_(max)),aspect ratio(R_(l/d)),shape,time-averaged wall shear stress(TAWSS),oscillatory shear index(OSI),and relative residence time(RRT).The results showed that:(1)In thrombosed aneurysms,there were several vortex structures(eddy zone),of which the position changed continuously in a cardiac cycle.In non-thrombosed aneurysms,the streamlines showed a large streaming zone.(2)Abnormal hemodynamic areas of aneurysms with thrombosis tended to appear in the same region(especially the proximal and near myocardial side of aneurysms).(3)In the non-thrombosed group,there was a correlation between the morphological and hemodynamic parameters.In thrombosed aneurysms,the flow pulsatility has a significant impact on the flow pattern.The thrombosed coronary aneurysms exhibited more risk factors and the co-location of hemodynamic abnormalities was consistent with the position of thrombosis.A score of risk factors could provide the thrombotic information of coronary aneurysms,which might be helpful for long-term clinical management of KD patients.

The exploration of flow pattern in the superior vena cava of healthy adults:A 4D flow magnetic resonance imaging study

Our study sought to investigate the blood flow pattern in the superior vena cava(SVC)of healthy adults and to describe the development and characteristics of the flow pattern using 4D flow magnetic resonance imaging(MRI).4D flow MRI data with full coverage of SVC and brachiocephalic veins(BVs)were acquired with a 3-Testa MRI in thirty healthy adults(age:28.70±9.09).Hemodynamic parameters in the SVC,including velocity,velocity vector,flow visualization(pathlines,streamlines),flow waveform and energy loss,were obtained with specialized commercial post-processing software based on 4D flow MRI data.This study found that:(1)The SVC has a pulsating flow waveform with double peaks.(2)Based on BVs flow of the SVC pathline visualization,flow patterns could be divided into three development types:twining(n=14),untwining(n=)and no helical flow(n=7).(3)With the decreasing blood velocity,helical flow areas tended to gradually extend.(4)There were no significant differences in most hemodynamic parameters among the three types.The exploration of the blood flow characteristics of normal SVC may be the first step for capturing pathogenic features before the patients develop symptoms with a certain positive significance.The potential physiological significance of these phenomena deserves more exploration in future studies.