Patient-specific haemodynamic simulations of complex aortic dissections informed by commonly available clinical datasets
Patient-specific haemodynamic simulations of complex aortic dissections informed by commonly available clinical datasets
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DOI：
10.1016/j.medengphy.2019.06.012
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发表时间：
2019-09-01
影响因子：
2.2
通讯作者：
Diaz-Zuccarini, Vanessa
中科院分区：
文献类型：
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作者：
Bonfanti, Mirko;Franzetti, Gaia;Diaz-Zuccarini, Vanessa
患者特异性计算流体动力学（CFD）可以通过提供复杂的主动脉内血流动力学的详细信息来辅助B型主动脉夹层（AD）的临床决策过程。这项研究提出了一种新的方法，用于实施个性化的CFD模型，使用非侵入性的，通常是最小的，数据集通常收集的AD监测。介绍了一种使用集总电容器在刚性壁模拟中计算动脉顺应性的创新方法，并提出了一种用于边界条件校准的参数估计策略。该方法在三个复杂的AD病例上进行了测试，结果与有创血压测量结果进行了成功的比较，血流动力学结果（例如腔内压力、管腔之间的流量分配、基于壁剪切应力的指数）提供了单独使用成像无法获得的信息，从而深入了解疾病的状态。观察到远端内膜瓣中的小撕裂导致两个管腔中的血流紊乱。此外，振荡压力跨内膜瓣经常观察到在接近的撕裂在腹部region.This研究表明，如何结合常用的临床数据与计算建模可以是一个强大的工具，以提高临床认识的AD，这可能表明的风险动态阻塞的真腔。(C)2019年IPEM。由爱思唯尔有限公司出版。保留所有权利。
Patient-specific computational fluid-dynamics (CFD) can assist the clinical decision-making process for Type-B aortic dissection (AD) by providing detailed information on the complex intra-aortic haemodynamics. This study presents a new approach for the implementation of personalised CFD models using non-invasive, and oftentimes minimal, datasets commonly collected for AD monitoring. An innovative way to account for arterial compliance in rigid-wall simulations using a lumped capacitor is introduced, and a parameter estimation strategy for boundary conditions calibration is proposed. The approach was tested on three complex cases of AD, and the results were successfully compared against invasive blood pressure measurements.Haemodynamic results (e.g. intraluminal pressures, flow partition between the lumina, wall shearstress based indices) provided information that could not be obtained using imaging alone, providing insight into the state of the disease. It was noted that small tears in the distal intimal flap induce disturbed flow in both lumina. Moreover, oscillatory pressures across the intimal flap were often observed in proximity to the tears in the abdominal region, which could indicate a risk of dynamic obstruction of the true lumen.This study shows how combining commonly available clinical data with computational modelling can be a powerful tool to enhance clinical understanding of AD. (C) 2019 IPEM. Published by Elsevier Ltd. All rights reserved.