基于CTA数据后处理对颈内动脉狭窄处血流动力学特点的研究  

Study on the hemodynamic characteristics of internal carotid artery stenosis based on CTA reprocessing

作　　者：孙玉玺 程哲 陈硕硕 巢青[1] 束汉生[1] SUN Yuxi;CHENG Zhe;CHEN Shuoshuo;CHAO Qing;SHU Hansheng(The Second Affiliated Hospital of Bengbu Medical College,Bengbu 233030,China)

机构地区：[1]蚌埠医学院第二附属医院,安徽蚌埠233030

出　　处：《中国实用神经疾病杂志》2024年第5期547-551,共5页Chinese Journal of Practical Nervous Diseases

基　　金：安徽省高等教育厅重点项目(编号:2022AH051423);安徽省高等教育厅重点项目(编号:2022AH051507);蚌埠医学院研究生科研创新项目(编号:Byycx22127)。

摘　　要：目的 基于头颈部CTA影像数据建立计算流体力学(CF)仿真模型,研究颈内动脉狭窄处的血流动力学特点。方法 回顾性分析蚌埠医学院第二附属医院2021-05—2023-03符合纳入标准的30例患者,运用脑血管三维重建技术对颈动脉及颈内动脉进行3D模型重建,并进行血流动力学参数分析测量及统计,测得颈内动脉狭窄处的壁面剪切应力(WSS)、时间平均壁面剪切应力(TAWSS)、震荡剪切指数(OSI)、相对滞留时间(RRT)并分析各项参数之间的相关性及差异性。结果 颈内动脉狭窄区域的WSS、TAWSS、OSI、RRT分别为58.669 3(43.882 0,65.979 2)、18.695 8(14.973 8,25.534 6)、0.074 6(0.063 3,0.085 4)、0.092 3(0.082 2,0.109 6),正常侧WSS、TAWSS、OSI、RRT分别为15.215 3(9.039 7,25.117 2)、5.138 2(3.373 4,6.139 9)、0.122 7(0.099 7,0.151 2)、0.712 3(0.519 0,0.821 7)。颈内动脉狭窄处的血流速度及血流量分别为1.925 9±0.125 5、4.374 1±0.277 9,正常侧的血流速度及血流量分别为0.992 6±0.074 7、6.190 7±0.260 9。狭窄区域的WSS、TAWSS明显增大,OSI和RRT相对较小,血流速度明显增大,同时伴随较小的血流量,差异均有统计学意义(P<0.05)。结论 颈内动脉狭窄处的血流动力学因素较正常侧发生明显变化,可通过CFD仿真模拟分析方法评估血流动力学因素变化程度,帮助分析颈内动脉狭窄患者的危险程度,辅助临床诊断、治疗及预后评估。Objective To study the hemodynamic characteristics of internal carotid artery stenosis by establishing a computational fluid dynamics(CFD)simulation model based on CTA image data of head and neck.Methods A retrospective analysis was performed on 30 patients who met the inclusion criteria in the Second Affiliated Hospital of Bengbu Medical College from May 2021 to March 2023.3D craniocerebral vascular reconstruction technology was used to conduct 3D model reconstruction of carotid artery and internal carotid artery,and hemodynamic parameters were analyzed,measured and statistically analyzed.The wall shear stress(WSS),time-average wall shear stress(TAWSS),oscillating shear index(OSI)and relative residence time(RRT)of internal carotid artery stenosis were measured,and the correlation and difference among the parameters were analyzed.Results The WSS,TAWSS,OSI and RRT in the narrow area of internal carotid artery were58.6693(43.8820,65.9792),18.6958(14.9738,25.5346),0.0746(0.0633,0.0854),0.0923(0.0822,0.1096),respectively.WSS,TAWSS,OSI and RRT on the normal side were 15.2153(9.0397,25.1172),5.1382(3.3734,6.1399),0.1227(0.0997,0.1512),0.7123(0.5190,0.8217),respectively.In addition,the blood flow velocity and blood flow of the narrow internal carotid artery were 1.9259±0.1255 and 4.3741±0.2779,respectively,and the blood flow velocity and blood flow of the normal side were 0.9926±0.0747 and6.1907±0.2609,respectively.WSS and TAWSS in the stenosis area were significantly increased,while OSI and RRT were relatively small,and the blood flow velocity was significantly increased,accompanied by a small blood flow,with statistical significance(P<0.05).Conclusion Compared with normal side,the hemodynamic factors of internal carotid artery stenosis were significantly changed.CFD simulation analysis method can be used to evaluate the degree of changes in hemodynamic factors to help analyzing the risk degree of patients with internal carotid artery stenosis,and assist clinical diagnosis,treatment and prognosis assessment.

关 键 词：颈内动脉狭窄 CT血管造影 头颈部 计算流体力学 血流动力学 

分 类 号：R743[医药卫生—神经病学与精神病学]