动脉粥样硬化斑块破坏的生物力学研究

发布时间：2018-05-08 19:08

本文选题：动脉粥样硬化斑块 + 生物力学　；参考：《东南大学》2016年博士论文

【摘要】：动脉粥样硬化斑块破裂及继发血栓形成是急性冠状动脉综合症和脑卒中等血管疾病发生的主要原因,本文根据斑块结构和病例数据探讨斑块破坏的生物力学机理,建立了一套基于医学影像数据和应力分析的动脉粥样硬化斑块破裂的早期识别和诊断方案。论文工作建立了反映动脉粥样硬化斑块微结构的理想生物力学模型,考虑了斑块外心肌组织与内腔边界约束、血压循环荷载等生理条件对斑块应力状态和破裂风险的影响,分析了钙化、炎症等非均质因素对易损斑块的作用。为引入临床病例的个体化和统计特性,对17位病人的磁共振成像(MRI)数据进行了分析,探讨了斑块应力状态对血管外壁轮廓的敏感度,并指出其相关特性；结合光学相干断层(OCT)和血管内超声(IVUS)技术对来自30位病人的53组冠状动脉斑块破裂的生物力学特性进行了研究,指出了斑块微结构与应力状态之间的统计关联特性,结合易损斑块经验判定准则(TCFA)进行了讨论。本文基于对斑块理想模型的探讨以及临床病例影像数据的分析,开发了包括图像配准分割、结构建模、应力计算、统计分析在内的可量化、程序化的斑块受损分析与风险评估方法。基于不断增长的海量医疗影响数据,本文的机理分析方法与结论有望在临床上用于对易损斑块的早期诊断与风险评估。
[Abstract]:Rupture of atherosclerotic plaque and secondary thrombosis are the main causes of vascular diseases such as acute coronary syndrome and stroke. The biomechanical mechanism of plaque destruction is discussed based on plaque structure and case data. An early detection and diagnosis scheme for atherosclerotic plaque rupture based on medical image data and stress analysis was established. An ideal biomechanical model reflecting the microstructures of atherosclerotic plaques was established in this paper. The effects of physiological conditions such as external myocardial tissue and internal cavity boundary constraints, blood pressure cyclic load on plaque stress state and rupture risk were considered. The effects of heterogeneous factors, such as calcification and inflammation, on vulnerable plaques were analyzed. In order to introduce individual and statistical characteristics of clinical cases, the magnetic resonance imaging (MRI) data of 17 patients were analyzed, and the sensitivity of plaque stress state to the contour of vascular wall was discussed, and the related characteristics were pointed out. Combined with optical coherence tomography (Oct) and intravascular ultrasound (IVUS) technique, the biomechanical characteristics of coronary plaque rupture in 53 groups from 30 patients were studied, and the statistical correlation between plaque microstructure and stress state was pointed out. TCFAs are discussed in combination with the empirical criterion of vulnerable plaques (TCFAs). Based on the discussion of the ideal plaque model and the analysis of the clinical case image data, the quantifiable images including image registration and segmentation, structural modeling, stress calculation and statistical analysis are developed in this paper. Programmed plaque damage analysis and risk assessment. Based on the increasing mass of medical impact data, the mechanism analysis methods and conclusions of this paper are expected to be used in the early diagnosis and risk assessment of vulnerable plaque.
【学位授予单位】：东南大学
【学位级别】：博士
【学位授予年份】：2016
【分类号】：R543.5

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