液态栓塞剂栓塞脑动静脉畸形的计算流体力学建模与仿真  

Computational modeling and simulation for endovascular embolization of cerebral arteriovenous malformations with liquid embolic agents

作　　者：张博文 陈曦 张晓龙 丁光宏 葛亮 王盛章 Bowen Zhang;Xi Chen;Xiaolong Zhang;Guanghong Ding;Liang Ge;Shengzhang Wang(Institute for biomechanics,Department of Aeronautics and Astronautics,Fudan University,Shanghai 200433,China;Department of Radiology,Huashan Hospital,Fudan University,Shanghai 200040,China;Shanghai Key Laboratory for Acupuncture Mechanism and Acupoint Function,Shanghai 200433,China;Institute of Biomedical Engineering&Technology,Academy of Engineering Technlogy,Fudan Universty,Shanghai 200433,China)

机构地区：[1]Institute for biomechanics,Department of Aeronautics and Astronautics,Fudan University,Shanghai 200433,China [2]Department of Radiology,Huashan Hospital,Fudan University,Shanghai 200040,China [3]Shanghai Key Laboratory for Acupuncture Mechanism and Acupoint Function,Shanghai 200433,China [4]Institute of Biomedical Engineering&Technology,Academy of Engineering Technlogy,Fudan Universty,Shanghai 200433,China

出　　处：《Acta Mechanica Sinica》2024年第1期281-295,共15页力学学报（英文版）

基　　金：supported by the National Natural Science Foundation of China(Grant No.11872152).

摘　　要：大脑动静脉畸形(AVMs)的血管内栓塞通常需要注射液态栓塞剂(LEAs)以减少畸形处的血流.在临床实践中,需要事先仔细规划注射LEAs的供血动脉以及LEAs的剂量.计算流体动力学可以模拟LEAs在畸形团内的注射过程,并在术前评估不同操作的治疗效果.应用多孔介质模型避免了AVMs的几何建模困难,并重现了血管瘤内复杂的血管网络结构.采用多相流模拟了LEAs与血液之间的相互作用.LEAs的黏度由其溶质乙烯-乙醇共聚物(EVOH)的浓度确定.通过求解物质输运方程计算了溶剂二甲基亚矾(DMSO)的扩散过程.通过构建EVOH浓度与黏度之间的关系,模拟了LEAs的凝固过程.LEAs的注射和凝固的数值模拟方法在两个特定患者的AVMs上进行了测试。计算预测了LEAs在畸形团内的流动方向。通过三维染可以很好地可视化注射的LEAs的形态.进行了定量分析,包括供血动脉和引流静脉的流量变化.利用计算流体动力学(CFD)方法可以模拟LEAs栓塞AVMs的过程,以展示不同栓塞手术规划的治疗效果,并确定最佳治疗方案.Endovascular embolization of arteriovenous malformations(AVMs)in the brain usually requires injecting liquid embolic agents(LEAs)to reduce blood flow through the malformation.In clinical procedures,the feeding artery into which the LEAs are injected,and the amount of LEAs needs to be carefully planned preoperatively.Computational fluid dynamics can simulate the injecting process of LEAs in nidus and evaluate the therapeutic effects of different procedures preoperatively.Applying a porous media model avoided the difficulties of geometric modeling of AvMs,and the complex vascular network structure within the nidus was reproduced.The multi-phase flow was applied to simulate the interaction between LEAs and blood.The viscosity of LEAs is determined by the concentration of its solute ethylene-vinyl alcohol copolymer(EVOH).The diffusion process of the solvent dimethyl sulfoxide(DMSO)was calculated by solving the species transport equation.The coagulation of LEAs was simulated by constructing the relationship between the concentration of EVOH and viscosity.The numerical simulation method of LEAs for injection and coagulation was tested on two patient-specific AVMs.The calculations predicted the flow direction of the LEAs in the nidus.The morphology of the injected LEAs could be well visualized by 3D rendering.Quantitative analysis was conducted,including flow rate changes at the feeding arteries and draining veins.The embolization process of AVMs with LEAs can be simulated by computational fluid dynamics(CFD)methods to show the therapeutic effects of different embolization procedure planning,the optimal treatment plan can be determined.

关 键 词：最佳治疗方案 供血动脉 血管内栓塞 脑动静脉畸形 计算流体力学 计算流体动力学 注射过程 血管瘤 

分 类 号：O3[理学—力学]