布-加综合征血流动力学参数模拟与其病因相关性分析  

Correlative analysis between simulated hemodynamic parameters and etiology of Budd-Chiari syndrome with stenosis of inferior vena cava

作　　者：赵英红[1] 平杰[2] 崔艳峰[2] 孙存杰[1,2] 刘颖[2] 胡通海[2] 

机构地区：[1]徐州医学院医学影像学院,江苏徐州221004 [2]徐州医学院附属医院,江苏徐州221006

出　　处：《军事医学》2013年第12期910-913,共4页Military Medical Sciences

基　　金：徐州市科技计划资助项目(XM12B011)

摘　　要：目的建立特征性下腔静脉狭窄型布-加综合征三维(3D)模型,分析血流动力学参数变化,探讨与布-加综合征病因相关的血流动力学因素。方法选取下腔静脉重度狭窄型布-加综合征病例,通过对其磁共振成像(MRI)数据的3D重建,采用计算机流体力学(CFD)软件进行血流动力学数值模拟,并与正常人的下腔静脉模型参数进行比较,分析其主要血流动力学参数变化。结果建立的下腔静脉3D流体模型揭示了病变区域的血流模式。随狭窄的出现及狭窄程度的加深,血管内血流模式发生明显改变,狭窄区域旁侧出现涡流;狭窄处血流流速急升,最大值可达(1.39±0.257)m/s;狭窄处壁面切应力明显升高,最大值可达(7.77±0.124)Pa,且沿血流流动方向产生较大梯度。结论血流模式的改变会进一步影响血管内血液的局部流速以及血管壁上切应力等参数的分布,这些可能是影响下腔静脉狭窄以致进一步恶化形成栓塞的因素。Objective To establish a three-dimensional（3D） numerical simulation model of typical Budd-Chiari syn- drome （BCS） with stenosis of inferior vena cava, and analyze the variation in hemodynamic parameters and to discuss the e- tiology-related hemodynamic factors in BCS. Methods A 3D model of enhanced MRI was established from a patient with BCS with stenosis of the inferior vena cava. Numerical simulation was conducted based on the data from the model using computational fluid dynamics （CFD） analysis. The data from the model were also compared with the parameters from the model of inferior vena cava without stenosis in order to analyze the variation in hemodynamic parameters of stenosis of inferi- or vena cava. Results The established 3D flow dynamic model of the inferior vena cava showed that there were marked var- iations in the blood flow pattern with the onset and aggravation of stenosis as well as vortex in the upper stenotic area. There was rapid increase in blood flow velocity, with the peak at （ 1.39 ±0. 257） m/s. Also a significant rise was observed in wall shear stress in the stenotic area, with its peak at （7.77 ± 0. 124） Pa, accompanied by great gradient variations. Con- clusion Alterations in the blood flow pattern can produce more impact on parameter distribution, including local intravas- cular blood flow rate and vascular wall shear stress, which might contribute to the stenosis of inferior vena cava and the con- sequent embolism.

关 键 词：布-加综合征 血流动力学 腔静脉 下 成像 三维 

分 类 号：R575[医药卫生—消化系统]