Simulations of congenital septal defect closure and reactivity testing in patient-specific models of the pediatric pulmonary vasculature: A 3D numerical study with fluid-structure interaction
Simulations of congenital septal defect closure and reactivity testing in patient-specific models of the pediatric pulmonary vasculature: A 3D numerical study with fluid-structure interaction
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DOI：
10.1115/1.2206202
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发表时间：
2006-08-01
影响因子：
1.7
通讯作者：
Shandas, Robin
中科院分区：
文献类型：
--
作者：
Hunter, Kendall S.;Lanning, Craig J.;Shandas, Robin
临床影像学方法在血管病变的诊断中非常有效，但它们目前还不能提供足够的细节来阐明这些疾病的原因或进展，并且很难预测手术干预的结果。通过临床成像方法与计算技术的结合，获得了血管血流动力学和动脉力学的更多细节和预测能力。从x线血管造影图像中获得儿童近端肺血管的三维、患者特异性几何重建，并通过商业计算软件进行网格化。两个这样的模型来自高血压患者，一个有多重间隔缺损，另一个进行血管反应性测试，每个模型都有两组合适的流体和结构初始和边界条件，并用于获得临床测量和预测构型下动脉壁运动和血流动力学的详细瞬态模拟。在鼻中隔缺损闭合的模拟中，输入流量和近端血管刚度减少，显示出近端速度、壁面剪切应力（WSS）和术后状态压力的显著降低。血管反应性模拟显示，在反应状态下，远端血管阻力和近端血管刚度降低，流速和WSS的变化可以忽略不计，但近端压力明显下降。与目前的医学成像方法相比，这种新的患者特异性技术提供了更多关于肺回路功能的细节，并有望实现手术计划。
Clinical imaging methods are highly effective in the diagnosis of vascular pathologies, but they do not currently provide enough detail to shed light on the cause or progression of such diseases, and would be hard pressed to foresee the outcome of surgical interventions. Greater detail of and prediction capabilities for vascular hemodynamics and arterial mechanics are obtained here through the coupling of clinical imaging methods with computational techniques. Three-dimensional, patient-specific geometric reconstructions of the pediatric proximal pulmonary vasculature were obtained from x-ray angiogram images and meshed for use with commercial computational software. Two such models from hypertensive patients, one with multiple septal defects, the other who underwent vascular reactivity testing, were each completed with two sets of suitable fluid and structural initial and boundary conditions and used to obtain detailed transient simulations of artery wall motion and hemodynamics in both clinically measured and predicted configurations. The simulation of septal defect closure, in which input flow and proximal vascular stiffness were decreased, exhibited substantial decreases in proximal velocity, wall shear stress (WSS), and pressure in the post-op state. The simulation of vascular reactivity, in which distal vascular resistance and proximal vascular stiffness were decreased, displayed negligible changes in velocity and WSS but a significant drop in proximal pressure in the reactive state. This new patient-specific technique provides much greater detail regarding the function of the pulmonary circuit than can be obtained with current medical imaging methods alone, and holds promise for enabling surgical planning.