基于高分辨率磁共振管壁成像的颅内动脉两相血流动力学分析  

Two-phase hemodynamic analysis of intracranial arteries based on high-resolution magnetic resonance tube wall imaging

作　　者：崔宇翔 蔡伟华 相菲 田园[3] 李露露[3] 郭宏[1] CUI Yuxiang;CAI Weihua;XIANG Fei;TIAN Yuan;LI Lulu;GUO Hong(Department of Cardiology,the First Affiliated Hospital of Harbin Medical University,Harbin 150000,China;School of Energy and Power Engineering,Northeast Electric Power University,Jilin 132012,China;Department of Nuclear Magnetic Resonance,the First Affiliated Hospital of Harbin Medical University,Harbin 150000,China)

机构地区：[1]哈尔滨医科大学附属第一医院心内科,黑龙江哈尔滨150000 [2]东北电力大学能源与动力工程学院,吉林吉林132012 [3]哈尔滨医科大学附属第一医院核磁共振科,黑龙江哈尔滨150000

出　　处：《中国医学物理学杂志》2024年第11期1421-1427,共7页Chinese Journal of Medical Physics

基　　金：国家自然科学基金(20220181874281)。

摘　　要：基于高分辨率磁共振管壁成像,采用逆向医学工程建模技术获取个体化缺血性脑卒中高发颅内动脉模型,通过建立3种颅内动脉模型,包括牛顿流体血液模型、非牛顿流体血液模型与两相流非牛顿流体血液模型,运用计算流体力学方法进行瞬态数值模拟,分析血液流场、壁面剪切力分布及红细胞体积分布等血流动力学参数,并探究其参与颅内动脉粥样硬化形成及进展的可能机制。研究发现血流速度在颈内动脉及大脑中动脉末端显著增加,局部血管出现低速涡流、扰动流,且管壁中心与边缘血流速度差异较大,外侧均存在明显低流速区域。狭窄的管壁在高速血流作用下会形成一个较为清晰的中心核心区域,边缘层变薄且红细胞体积分数相对较低。在边缘层低红细胞分布与管壁外侧低流速的共同作用下,加剧血管内皮细胞坏死、缺氧、内皮功能障碍并导致动脉粥样硬化。相较于牛顿流体血液模型、非牛顿流体血液模型,两相流非牛顿流体血液模型对于血流动力学参数具有较大差异性,在模拟血液流动方面表现出更高的逼真度,为临床脑血管疾病的诊治提供参考。Based on high-resolution magnetic resonance tube wall imaging,reverse medical engineering modeling techniques are used to obtain individualized intracranial artery models of high prevalence in ischemic stroke.Three types of intracranial artery models,including Newtonian fluid model,non-Newtonian fluid model and non-Newtonian fluid with two-phase flow model,are established for transient numerical simulations using computational fluid dynamics method.The hemodynamic parameters such as blood flow field,wall shear stress distribution and erythrocyte volume distribution are analyzed to investigate the possible mechanisms involved in the formation and progression of intracranial atherosclerosis.It is found that blood flow velocity increased significantly at the end of the internal carotid artery and the middle cerebral artery.Low-speed vortex flow and disturbed flow appear in the local vessels.The difference in blood flow velocity between the center and the edge of the wall is large,with an obvious lowflow velocity area on the outer side.A clear central core area is formed in the stenotic wall under the action of high-speed blood flow,resulting in thinner edge layer and lower erythrocyte volume fraction.The combination of low erythrocyte distribution in the edge layer and low flow velocity on the outer side of the wall exacerbates endothelial cell necrosis,hypoxia,endothelial dysfunction,and leads to atherosclerosis.Compared with Newtonian and non-Newtonian fluid models,non-Newtonian fluid with two-phase flow model has greater variability for hemodynamic parameters and shows higher fidelity in simulating blood flow,which provides a reference for clinical diagnosis and treatment of cerebrovascular diseases.

关 键 词：缺血性脑卒中 颅内动脉 两相流 非牛顿流体 血液动力学 磁共振血管成像 

分 类 号：R318.01[医药卫生—生物医学工程] R811[医药卫生—基础医学]