| 张娅,宗会迁,王萌,魏昊业,杨存.数值模拟技术预测颈动脉支架植入术治疗颈动脉重度狭窄效果[J].中国医学影像技术,2021,37(12):1874~1879 |
| 数值模拟技术预测颈动脉支架植入术治疗颈动脉重度狭窄效果 |
| Numerical simulation for predicting effect of carotid artery stenting for treating severe carotid stenosis |
| 投稿时间：2020-07-31 修订日期：2021-09-24 |
| DOI：10.13929/j.issn.1003-3289.2021.12.027 |
| 中文关键词: 颈动脉 狭窄 支架 数值模拟 血流动力学 血管造影术 |
| 英文关键词:carotid arteries stenosis stents numerical simulation hemodynamics angiography |
| 基金项目:河北省卫计委青年科技研究计划（20210730）。 |
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| 中文摘要: |
| 目的 观察以数值模拟技术预测颈动脉支架植入术（CAS）治疗颈动脉重度狭窄效果的价值。方法 采用Mimics和Geomagic软件对1例因右侧颈内动脉重度狭窄拟行颈内动脉支架植入术的女性患者的CT血管成像（CTA）DICOM格式数据进行三维重建，获得颈动脉狭窄三维模型；再以Solidworks软件模拟CAS，获得术后颈动脉三维模型；最后以ANSYS FLUENT软件计算模型血流动力学，获得相关血流动力学参数，评估模拟CAS的治疗效果。结果 模拟CAS前，颈动脉狭窄处血流速度及壁面切应力较高而壁面压力较低，且存在二次流、涡流、回流及流动分离；颈动脉整体壁面切应力及壁面压力分布不均；颈内、颈外动脉血流灌注比为0.34，颈内、颈总动脉血流灌注比为0.25。模拟CAS后，该处血流速度及壁面切应力均降低，壁面压力升高，且二次流、回流、涡流及流动分离基本消失；颈动脉整体壁面切应力及壁面压力分布较均匀；颈内、颈外动脉血流灌注比为0.63，颈内、颈总动脉血流灌注比为0.62。结论 采用数值模拟技术可于CAS前有效预测其治疗重度颈动脉狭窄的疗效。 |
| 英文摘要: |
| Objective To observe the value of numerical simulation for predicting effect of carotid artery stenting (CAS) in treatment of severe carotid stenosis. Methods DICOM CT angiography (CTA) data of a female severe right internal carotid artery stenosis patient who would undergo internal carotid artery stent implantation were reconstructed with Mimics and Geomagic software to obtain a three-dimensional model of carotid stenosis. Solidworks software was then used to simulate CAS and obtain a three-dimensional model of carotid artery after CAS. Finally, the hemodynamics of the model after simulated CAS were calculated with ANSYS FLUENT software, and relevant hemodynamic parameters were obtained to evaluate the therapeutic effect of the simulated CAS. Results Before simulated CAS, the blood flow velocity and wall shear stress of arterial stenosis were both high, while wall pressure was low, and secondary flow, vortex, reflux and flow separation were observed. The distribution of wall shear stress and wall pressure of carotid artery was uneven. The blood perfusion ratio of internal and external carotid artery was 0.34, of internal and common carotid artery was 0.25. After simulated CAS, the blood flow velocity and wall shear stress decreased, while wall pressure increased, and most of the secondary flow, reflux, vortex and flow separation disappeared. The distribution of wall shear stress and wall pressure of carotid artery became uniform. The blood perfusion ratio of internal and external carotid artery was 0.63, of internal and common carotid artery was 0.62. Conclusion Numerical simulation could effectively predict the efficacy of CAS for treatment of severe carotid stenosis before operation. |
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