[1]周治军,王 哲,赵珅宇,等.基于计算流体力学的腹主动脉瘤破裂风险研究 [J].介入放射学杂志,2020,29(08):763-767.
　ZHOU Zhijun,WANG Zhe,ZHAO Shenyu,et al.Study on the rupture risks of abdominal aortic aneurysm based on computational fluid dynamics[J].journal interventional radiology,2020,29(08):763-767.
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基于计算流体力学的腹主动脉瘤破裂风险研究
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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
29
期数:
2020年08
页码:
763-767
栏目:
心脏介入
出版日期:
2020-08-25

文章信息/Info

Title:
Study on the rupture risks of abdominal aortic aneurysm based on computational fluid dynamics
作者:
周治军;  王 哲;  赵珅宇;  李凤贺;  王 成;  赵 渝
Author(s):
ZHOU Zhijun;  WANG Zhe;  ZHAO Shenyu;  LI Fenghe;  WANG Cheng;  ZHAO Yu.
Department of Vascular Surgery， First Affiliated Hospital of Chongqing Medical University， Chongqing 400016， China
关键词:
【关键词】 腹主动脉瘤;  计算流体力学;  壁面剪切力;  血栓指数
文献标志码:
A
摘要:
【摘要】 目的 通过分析真实腹主动脉瘤（AAA）血流动力学参数和血栓指数，探索AAA破裂的风险。 方法 回顾性分析重庆医科大学附属第一医院2016年2月至2018年9月收治的12例破裂AAA（破裂组）和26例未破裂AAA（未破裂组）患者，获取患者CTA图像资料。采用计算流体力学（CFD）方法得到AAA血流动力学参数和血栓指数，并分析两组动脉瘤血流动力学特征。结果 破裂组动脉瘤破裂区域、血流最大冲击区域壁面剪切力分别为（0.031±0.017） Pa、（0.630±0.215） Pa，差异有显著统计学意义（P＜0.001）；未破裂组动脉瘤血流最大冲击区域壁面剪切力为（1.345±0.253） Pa，与破裂组差异有显著统计学意义（P＜0.001）。破裂组腔内血栓指数在瘤体最大直径平面为平均0.551±0.188，在破裂平面为平均0.630±0.190，差异有显著统计学意义（P＜0.002）；未破裂组腔内血栓指数在瘤体最大直径平面为平均0.525±0.188，与破裂组差异无统计学意义（P=0.699）。 结论 血流动力学参数结合腔内血栓指数对预测AAA破裂起到一定作用。

参考文献/References:

［1］ Laine MT， Laukontaus SJ， Kantonen I， et al. Population- based study of ruptured abdominal aortic aneurysm［J］. Br J Surg， 2016， 103： 1634- 1639.
［2］ 鲁 刚， 黄 磊， 张晓龙，等． 颅内动脉瘤壁切应力与动脉瘤破裂关系的初步研究——基于患者的三维计算机模拟［J］． 介入放射学杂志， 2009， 18：568- 571．
［3］ 刘 莹，罗院明，殷艳飞，等． 动脉内流- 固耦合作用下两相血流动力学数值模拟［J］． 介入放射学杂志， 2017， 26：253- 257．
［4］ Algabri YA， Rookkapan S， Gramigna V， et al. Computational study on hemodynamic changes in patient- specific proximal neck angulation of abdominal aortic aneurysm with time- varying velocity［J］. Australas Phys Eng Sci Med， 2019， 42： 181- 190.
［5］ Doyle BJ， Cloonan AJ， Walsh MT， et al. Identification of rupture locations in patient- specific abdominal aortic aneurysms using experimental and computational techniques［J］. J Biomech， 2010， 43： 1408- 1416.
［6］ Qiu Y， Yuan D， Wen J， et al. Numerical identification of the rupture locations in patient- specific abdominal aortic aneurysms- using hemodynamic parameters［J］. Comput Methods Biomech Biomed Engin， 2018， 21： 1- 12.
［7］ Casciaro ME， Dottori J， El- Batti S， et al. Effects on aortoiliac fluid dynamics after endovascular sealing of abdominal aneurysms［J］. Vasc Endovascular Surg， 2018， 52： 621- 628.
［8］ Rawat DS， Pourquie M， Poelma C. Numerical investigation of turbulence in abdominal aortic aneurysms［J］. J Biomech Eng， 2019，［Online ahead of print］.
［9］ Wanhainen A， Verzini F， Van Herzeele IA， et al. Editor’s choice - European Society for Vascular Surgery（ESVS） 2019 clinical practice guidelines on the management of abdominal aorto- iliac artery aneurysms［J］. Eur J Vasc Endovasc Surg， 2019， 57： 8- 93.
［10］ Droz NM， Miner J， Pecchioni L. An 18- cm unruptured abdominal aortic aneurysm［J］. J Vasc Surg Cases Innov Tech， 2017， 3： 16- 19.
［11］ Siika A， Lindquist Liljeqvist M， Zommorodi S， et al. A large proportion of patients with small ruptured abdominal aortic aneurysms are women and have chronic obstructive pulmonary disease［J］. PLoS One， 2019， 14： e0216558.
［12］ Skibba AA， Evans JR， Hopkins SP， et al. Reconsidering gender relative to risk of rupture in the contemporary management of abdominal aortic aneurysms［J］. J Vasc Surg， 2015， 62： 1429- 1436.
［13］ Georgakarakos E， Ioannou CV， Volanis S， et al. The influence of intraluminal thrombus on abdominal aortic aneurysm wall stress［J］. Int Angiol， 2009， 28： 325- 333.
［14］ Miura Y， Ishida F， Umeda Y， et al. Low wall shear stress is independently associated with the rupture status of middle cerebral artery aneurysms［J］. Stroke， 2013， 44： 519- 521.
［15］ Boyd AJ， Kuhn DC， Lozowy RJ， et al. Low wall shear stress predominates at sites of abdominal aortic aneurysm rupture［J］. J Vasc Surg， 2016， 63： 1613- 1619.
［16］ Cebral JR， Sheridan M， Putman CM. Hemodynamics and bleb formation in intracranial aneurysms［J］. AJNR Am J Neuroradiol， 2010， 31： 304- 310.
［17］ Metaxa E， Tremmel M， Natarajan SK， et al. Characterization of critical hemodynamics contributing to aneurysmal remodeling at the basilar terminus in a rabbit model［J］. Stroke， 2010， 41： 1774- 1782.
［18］ Zambrano BA， Gharahi H， Lim C， et al. Association of intraluminal thrombus， hemodynamic forces， and abdominal aortic aneurysm expansion using longitudinal CT images［J］. Ann Biomed Eng， 2016， 44： 1502- 1514.
［19］ Vorp DA， Lee PC， Wang DH， et al. Association of intraluminal thrombus in abdominal aortic aneurysm with local hypoxia and wall weakening［J］. J Vasc Surg， 2001， 34： 291- 299.
［20］ Kazi M， Thyberg J， Religa P， et al. Influence of intraluminal thrombus on structural and cellular composition of abdominal aortic aneurysm wall［J］. J Vasc Surg， 2003， 38： 1283- 1292.
［21］ Chaikof EL， Dalman RL， Eskandari MK， et al. The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm［J］. J Vasc Surg， 2018， 67： 2.e2- 77.e2.

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备注/Memo

备注/Memo:
（收稿日期：2019- 07- 31）
（本文编辑：边 佶）
更新日期/Last Update: 2020-08-16