颈动脉狭窄行支架置入术前术后血流动力学数值模拟

发布时间：2018-03-01 06:23

本文关键词： 颈段颈动脉狭窄颈动脉支架置入术血流动力学数值模拟壁面剪切应力　出处：《大连医科大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的：通过患者的数字减影血管造影(Digital Subtraction Angiography,DSA)图片数据，应用计算机流体力学数值模拟方法建立特异性二维颈段颈动脉血流动力学模型，评估颈动脉支架置入术前与术后颈动脉狭窄段血流动力学的特征。方法：经DSA导出10名因颈段颈动脉狭窄行支架置入术前术后的原始图像，利用Photoshop软件截取狭窄段术前术后的轮廓；应用Matlab软件获取狭窄段轮廓的二维坐标，再利用Gambit软件重新形成狭窄段的外形，并进行二维网格划分并设定边界条件，最后应用Fluent软件进行血流动力学数值模拟计算，对比支架置入术前与术后壁面剪切应力、压力和血流速度等相关参数的变化。结果：经过数值模拟计算后得出：对比术前，术后狭窄段及狭窄段远端的血流动力学指标有明显的变化。平均术前狭窄段血流速度为7.83±5.00m/s，术后为2.18±0.66m/s，P0.05；平均术前狭窄段远端血流速度为0.72±0.35m/s，术后为1.91±0.22m/s， P0.05；平均术前狭窄段压力值为9008±2211.01Pa，术后为13460±1655.43Pa，P0.05；平均术前狭窄段远端压力值为3562±1536.18Pa，术后为11677±2524.57Pa，P0.05；平均术前狭窄段WSS为3.57±2.68Pa，术后为0.95±0.36Pa，，P0.05。结论：狭窄率超过95%的颈动脉的特异性二维血流动力学数值模拟是可行的；数值模拟是评估CAS前、后血流动力学特征的较好方法；对比CAS术前，术后颈动脉狭窄段血流速度降低，狭窄段远端血流速度升高，狭窄段压力值升高、狭窄段远端压力值升高，狭窄段WSS降低。
[Abstract]:Objective: to establish a specific two-dimensional carotid artery hemodynamic model by using digital subtraction angiography (DSA) image data and computer fluid dynamics (CFD) numerical simulation. To evaluate the hemodynamic characteristics of carotid stenosis before and after carotid stenting. Methods: the original images of 10 patients with carotid artery stenosis before and after stenting were obtained by DSA. The contours of the stenosis segments were intercepted by Photoshop software, and the 2D coordinates of the stenotic segments were obtained by Matlab software. Gambit software was used to reconstruct the shape of the narrow segment, and two-dimensional mesh was used to set the boundary conditions. Finally, the hemodynamic numerical simulation was carried out with Fluent software, and the wall shear stress before and after stent implantation was compared. Changes of pressure and blood flow velocity. Results: after numerical simulation, it was concluded that, The mean blood flow velocity of stenosis segment was 7.83 卤5.00 m / s before operation, 2.18 卤0.66 m / s / s after operation, 0.72 卤0.35 m / s before operation, 1.91 卤0.22 m / s, P 0.05 before operation, and 2.18 卤0.66 m / s / s after operation, respectively. The pressure value was 9008 卤2211.01 Paa, 13460 卤1655.43 Paa P0.05, the mean distal pressure of stenosis segment was 3562 卤1536.18 Paa, postoperative 11677 卤2524.57 PaP0.05, the mean preoperative stenosis segment WSS was 3.57 卤2.68 Paa, and the postoperative mean stenosis segment was 0.95 卤0.36PaP0.05. Conclusion: it is feasible to simulate the specific two-dimensional hemodynamics of carotid artery with stenosis rate of more than 95%. Numerical simulation is a good method to evaluate the hemodynamic characteristics before and after CAS. After operation, the blood flow velocity of carotid artery stenosis segment decreased, the distal end blood flow velocity of stenosis segment increased, the pressure value of stenosis segment increased, the distal pressure value of stenosis segment increased, and WSS of stenosis segment decreased.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R653;R816.2

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