4-D Flow MRI-Based Computational Analysis of Blood Flow in Patient-Specific Aortic Dissection
4-D Flow MRI-Based Computational Analysis of Blood Flow in Patient-Specific Aortic Dissection
复制标题
基于 4-D 流 MRI 的患者特异性主动脉夹层血流计算分析
DOI：
10.1109/tbme.2019.2904885
复制
发表时间：
2019-12-01
影响因子：
4.6
通讯作者：
Xu, Xiao Yun
中科院分区：
文献类型：
--
作者：
Pirola, Selene;Guo, Baolei;Xu, Xiao Yun
目的：主动脉夹层的计算血流动力学研究通常将患者特定的几何形状与理想化或通用的边界条件结合起来。在这项研究中，我们提出了一种基于完全患者特定边界条件的 B 型主动脉夹层 (TBAD) 血流动力学模拟的综合方法。方法：对 TBAD 患者进行术前四维 (4-D) 血流磁共振成像 (MRI) 和多普勒线压力测量（术前和术后）。这些数据用于导出胸腔血管内修复 (TEVAR) 前后血流计算模型的边界条件。通过将预测的血流模式与 TEVAR 之前的 4-D 血流 MRI 以及压力与体内测量结果进行比较，对计算结果进行了验证。结果和结论：瞬时速度流线的比较显示与 4-D 流 MRI 具有良好的定性一致性。预测压力与压力测量值的定量比较显示最大差异为 11 mmHg (-9.7%)。此外，与相应的测量值 72/118 mmHg 和 64/114 mmHg 相比，我们的模型正确预测了真实管腔压力从 TEVAR 前的 74/115 mmHg 降低到 TEVAR 后的 64/107 mmHg（泪液入口处的舒张压/收缩压）。这表明 TEVAR 前 4D 流 MRI 可用于调整 TEVAR 后血流动力学分析的边界条件。
Objective: Computational hemodynamic studies of aortic dissections usually combine patient-specific geometries with idealized or generic boundary conditions. In this study, we present a comprehensive methodology for the simulation of hemodynamics in type B aortic dissection (TBAD), based on fully patient-specific boundary conditions. Methods: Pre-operative four-dimensional (4-D) flow magnetic resonance imaging (MRI) and Doppler-wire pressure measurements (pre- and post-operative) were acquired from a TBAD patient. These data were used to derive boundary conditions for computational modeling of flow before and after thoracic endovascular repair (TEVAR). Validations of the computational results were performed by comparing predicted flow patterns with pre-TEVAR 4-D flow MRI, as well as pressures with in vivo measurements. Results and Conclusion: Comparison of instantaneous velocity streamlines showed a good qualitative agreement with 4-D flow MRI. Quantitative comparison of predicted pressures with pressure measurements revealed a maximum difference of 11 mmHg (-9.7%). Furthermore, our model correctly predicted the reduction of true lumen pressure from 74/115 mmHg pre-TEVAR to 64/107 mmHg post-TEVAR (diastolic/systolic pressures at entry tear level), compared to the corresponding measurements of 72/118 mmHg and 64/114 mmHg. This demonstrates that pre-TEVAR 4D flow MRI can be used to tune boundary conditions for post-TEVAR hemodynamic analyses.