Hemodynamic study of the therapeutic effects of the different degrees of sigmoid sinus diverticulum reconstruction on patients
Hemodynamic study of the therapeutic effects of the different degrees of sigmoid sinus diverticulum reconstruction on patients
复制标题
不同程度乙状窦憩室重建术对患者治疗效果的血流动力学研究
DOI：
10.1016/j.medengphy.2020.10.008
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发表时间：
2020-12-01
影响因子：
2.2
通讯作者：
Wang, Zhenchang
中科院分区：
文献类型：
--
作者：
Huang, Suqin;Li, Xiaoshuai;Wang, Zhenchang
乙状窦憩室（SSD）是搏动性耳鸣（PT）的常见病理生理学改变，主要通过SSD重建手术进行治疗。重建程度是SSD重建手术的重要指标，但其对SSD重建效果的影响尚不清楚。本研究旨在阐明SSD重建程度对憩室重建手术治疗的影响。根据PT患者的计算机断层扫描血管造影（CTA）图像重建1例患者特定病例（对照受试者）。SSD重建程度作为一个新的指标，在这项研究中。并构建对照受试者憩室重建程度为30%（病例1）、60%（病例2）和100%（病例3）的病例。瞬态计算流体动力学进行。计算室壁压力分布、室壁平均压力（Pavg）、流态（速度流线和速度矢量）、室壁切应力（WSS）和平均WSS（WSSavg），并用于评价DRD患者之间的血流动力学差异。结果表明，SSD压力的变化与DRD的增加不是线性的。DRD达到原憩室的60%是有效的。在入口边界条件的峰值点（T1 = 0.22s），SSD的Pavg具有非线性变化（对照受试者，126.967 Pa vs.情况1，126.274 Pa vs.情况2，106.897 Pa vs.情况3，94.116 Pa）。随着DRD的增加，流动涡度逐渐减小，流线光滑度逐渐增加。WSSavg随DRD的增加略有变化。高速流动的血液撞击憩室入口，然后旋转撞击乙状窦壁异常区域。得出的结论是，与PT相关的流动模式与DRD不同。在憩室重建手术中，有一个阈值，只有当DRD超过这个值（60%或70%或80%）时，才会有明显的效果。在本研究中，DRD至少应达到原始憩室的60%。当DRD不足时，憩室的血流动力学变化较小，PT可能仍然存在。SSD可能是由高速血流引起的。(c)2020年IPEM。由爱思唯尔有限公司出版。保留所有权利。
Sigmoid sinus diverticulum (SSD) is a common pathophysiology of pulsatile tinnitus (PT) and mainly treated by SSD reconstruction surgery. The degree of reconstruction is an important indicator of SSD reconstruction surgery, but its impact on the effect of SSD reconstruction is unclear. This study aimed to clarify the effect of the degree of SSD reconstruction on diverticulum reconstruction surgical treatment. One patient-specific case (control subject) was reconstructed based on the computed tomography angiography (CTA) images of patients with PT. The SSD reconstruction degree was used as a new index in this study. And the case of 30% (case 1), 60% (case 2), and 100% (case 3) of the diverticulum reconstruction degree of control subject were constructed. Transient-state computational fluid dynamics was performed. Wall pressure distribution, wall average pressure (Pavg) of SSD, flow pattern (velocity streamlines and velocity vector), wall shear stress (WSS) and averaged WSS (WSSavg) were calculated and used in evaluating the hemodynamic differences among the DRD cases. Results demonstrated that change in SSD pressure was not linear with increase in DRD. The DRD that reached 60% of the original diverticulum was effective. At the peak point of the inlet boundary condition (T1 = 0.22s), the Pavg of SSD had a nonlinear change (control subject, 126.967 Pa vs. case 1, 126.274 Pa vs. case 2, 106.897 Pa vs. case 3, 94.116 Pa). Flow vorticity decreased gradually, and the smoothness of the streamlines increased with DRD. WSSavg slightly changed with increasing DRD. The high-speed flow blood hit the diverticulum entrance and then swirled to hit the area of the sigmoid sinus wall abnormal. It was concluded that flow patterns related to PT differ with DRD. In diverticulum reconstruction surgery, there is a threshold value, and only when the DRD exceeds this value (60% or 70% or 80%), it will have a noticeable effect. In this study, DRD should at least reach 60% of the original diverticulum. When DRD is insufficient, hemodynamic change in the diverticulum is small, and the PT may have remained. SSD may be caused by high-speed blood flow. (c) 2020 IPEM. Published by Elsevier Ltd. All rights reserved.