Hemodynamic effects of entry and exit tear size in aortic dissection evaluated with in vitro magnetic resonance imaging and fluid-structure interaction simulation.
Hemodynamic effects of entry and exit tear size in aortic dissection evaluated with in vitro magnetic resonance imaging and fluid-structure interaction simulation.
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DOI：
10.1038/s41598-023-49942-0
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发表时间：
2023-12-18
影响因子：
4.6
通讯作者：
中科院分区：
文献类型：
--
作者：
了解主动脉夹层的形态学和血流动力学特征之间复杂的相互作用对于危险分层和个体化治疗的发展至关重要。本研究通过比较流体-结构相互作用（FSI）模拟与体外4D流动磁共振成像（MRI），评价了B型主动脉夹层动脉瘤入口和出口撕裂大小对血流动力学的影响。将基线患者特定的3D打印模型和两种具有修改的撕裂尺寸（较小的入口撕裂，较小的出口撕裂）的变体嵌入到流量和压力控制设置中，以进行MRI以及基于12点导管的压力测量。相同的模型定义了FSI模拟的壁和流体域，其边界条件与测量数据相匹配。结果表明，非常匹配的复杂的流动模式之间的4D流MRI和FSI模拟。与基线模型相比，假腔流量减少，入口撕裂更小（FSI模拟和4D-flow MRI分别为-17.8%和-18.5%）或出口撕裂更小（-16.0%和-17.3%）。真假腔压差（最初分别为11.0和7.9 mmHg，用于FSI模拟和基于导管的压力测量）随着入口撕裂（28.9和14.6 mmHg）的减小而增大，随着出口撕裂（− 20.6和− 13.2 mmHg）的减小而变为负值。这项工作建立了定量和定性的影响，入口或出口撕裂的大小对血流动力学在主动脉夹层，特别是显着的影响，观察到FL加压。FSI模拟证明了与血流成像的可接受的定性和定量一致性，支持其在临床研究中的部署。
Understanding the complex interplay between morphologic and hemodynamic features in aortic dissection is critical for risk stratification and for the development of individualized therapy. This work evaluates the effects of entry and exit tear size on the hemodynamics in type B aortic dissection by comparing fluid–structure interaction (FSI) simulations with in vitro 4D-flow magnetic resonance imaging (MRI). A baseline patient-specific 3D-printed model and two variants with modified tear size (smaller entry tear, smaller exit tear) were embedded into a flow- and pressure-controlled setup to perform MRI as well as 12-point catheter-based pressure measurements. The same models defined the wall and fluid domains for FSI simulations, for which boundary conditions were matched with measured data. Results showed exceptionally well matched complex flow patterns between 4D-flow MRI and FSI simulations. Compared to the baseline model, false lumen flow volume decreased with either a smaller entry tear (− 17.8 and − 18.5%, for FSI simulation and 4D-flow MRI, respectively) or smaller exit tear (− 16.0 and − 17.3%). True to false lumen pressure difference (initially 11.0 and 7.9 mmHg, for FSI simulation and catheter-based pressure measurements, respectively) increased with a smaller entry tear (28.9 and 14.6 mmHg), and became negative with a smaller exit tear (− 20.6 and − 13.2 mmHg). This work establishes quantitative and qualitative effects of entry or exit tear size on hemodynamics in aortic dissection, with particularly notable impact observed on FL pressurization. FSI simulations demonstrate acceptable qualitative and quantitative agreement with flow imaging, supporting its deployment in clinical studies.
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影响因子：
3.8
作者：
Lan, Ingrid S.;Liu, Ju;Marsden, Alison L.
通讯作者：
Marsden, Alison L.
DOI：
10.1002/cnm.2780
发表时间：
2017-01-01
影响因子：
2.1
作者：
Al-Azawy, Mohammed G.;Turan, A.;Revell, A.
通讯作者：
Revell, A.
影响因子：
3.1
作者：
Chiu, Peter;Miller, D. Craig
通讯作者：
Miller, D. Craig
影响因子：
3.5
作者：
Baeumler, Kathrin;Vedula, Vijay;Fleischmann, Dominik
通讯作者：
Fleischmann, Dominik
影响因子：
4.4
作者：
Garg, Pankaj;Westenberg, Jos J. M.;Plein, Sven
通讯作者：
Plein, Sven