Aneurysmal growth in type-B aortic dissection: assessing the impact of patient-specific inlet conditions on key haemodynamic indices.
Aneurysmal growth in type-B aortic dissection: assessing the impact of patient-specific inlet conditions on key haemodynamic indices.
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DOI：
10.1098/rsif.2023.0281
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发表时间：
2023-09
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--
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B型主动脉夹层是一种心血管疾病，其中在降主动脉的内膜层中产生撕裂，使得加压血液使血管壁分层。在药物治疗的患者中，假腔（FL）的长期囊状扩张被认为几乎是不可避免的，并且与较差的疾病结局相关。虽然驱动FL扩张的病理生理机制尚不清楚，但血液动力学因素被认为起着关键作用。计算流体动力学（CFD）和4D流动MRI（4DMR）分析揭示了流动螺旋度，振荡壁剪切应力和FL的血管扩张之间的相关性。在这项研究中，我们比较了使用患者特异性，三维，从4DMR数据中提取的三分量入口速度剖面（4D IVP）与流速模拟结果对比-匹配的均匀和轴向速度分布，在没有4DMR的情况下仍然广泛使用。我们还通过将4D IVP缩放到先前研究中检测到的成像误差的程度来评估4DMR数据中测量误差的影响。我们观察到振荡剪切和螺旋度对整个FL的入口速度分布和流量高度敏感，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。
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.
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影响因子：
3.9
作者：
Markodimitrakis, Emmanouil;Lin, Siyu;Koutoulakis, Emmanouil;Marin-Castrillon, Diana Marcela;Saez, Francisco Aaron Tovar;Leclerc, Sarah;Bernard, Chloe;Boucher, Arnaud;Presles, Benoit;Bouchot, Olivier;Decourselle, Thomas;Morgant, Marie-Catherine;Lalande, Alain
通讯作者：
Lalande, Alain
影响因子：
4.6
作者：
Cherry, Molly;Khatir, Zinedine;Khan, Amirul;Bissell, Malenka
通讯作者：
Bissell, Malenka
影响因子：
4.3
作者：
通讯作者：
--
影响因子：
2.4
作者：
Morbiducci, Umberto;Ponzini, Raffaele;Rizzo, Giovanna
通讯作者：
Rizzo, Giovanna
DOI：
10.3174/ajnr.a3678
发表时间：
2014-02
期刊：
AJNR. American journal of neuroradiology
影响因子：
--
作者：
Byrne G;Mut F;Cebral J
通讯作者：
Cebral J